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Related Concept Videos

Diagnosing Acidosis and Alkalosis01:24

Diagnosing Acidosis and Alkalosis

303
Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2  and...
303

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Related Experiment Video

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Update on Measuring Ketones.

Jingtong Huang1, Andrea M Yeung1, Richard M Bergenstal2

  • 1Diabetes Technology Society, Burlingame, CA, USA.

Journal of Diabetes Science and Technology
|February 16, 2023
PubMed
Summary
This summary is machine-generated.

Ketone bodies are vital energy sources during low carbohydrate states. Measuring ketones in blood, urine, or breath aids in managing diabetic ketoacidosis (DKA) and monitoring various health conditions.

Keywords:
SGLT2 inhibitorscontinuous ketone monitordiabetesdiabetic ketoacidosisinsulinketones

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Area of Science:

  • Endocrinology and Metabolism
  • Biochemistry
  • Clinical Diagnostics

Background:

  • Ketone bodies (beta-hydroxybutyrate, acetoacetate) are liver-produced energy substrates utilized during low carbohydrate availability.
  • Elevated ketone levels are characteristic of insulin insufficiency and diabetic ketoacidosis (DKA).
  • DKA involves increased lipolysis and hepatic conversion of free fatty acids into ketone bodies.

Purpose of the Study:

  • To review challenges and limitations in current ketone testing for diabetes management.
  • To summarize emerging trends and technologies in ketone body measurement.
  • To highlight the clinical utility of ketone testing in various health scenarios.

Main Methods:

  • Review of existing literature and FDA-cleared point-of-care ketone tests (blood and urine).
  • Discussion of emerging technologies for breath and interstitial fluid ketone analysis.
  • Analysis of ketone measurement applications in DKA, diet adherence, and drug-induced acidosis.

Main Results:

  • Beta-hydroxybutyrate is predominant in blood during DKA, while acetoacetate dominates urine during resolution, causing a testing lag.
  • FDA-cleared point-of-care tests exist for blood and urine ketones (beta-hydroxybutyrate and acetoacetate).
  • Breath acetone measurement lacks FDA-cleared devices; interstitial fluid beta-hydroxybutyrate technology is emerging.

Conclusions:

  • Ketone testing is valuable for DKA identification, monitoring, and assessing risks associated with certain medications (SGLT2 inhibitors, immune checkpoint inhibitors) and alcohol use.
  • Understanding the dynamics of ketone body measurement across different fluids is crucial for accurate clinical interpretation.
  • Advancements in ketone testing technology promise improved diagnostics and patient management in diabetes and related conditions.