Endocrine Abstracts

Background: Current criteria for the diagnosis of diabetic ketoacidosis (DKA) are limited by their nonspecificity (serum bicarbonate [HCO3] and pH) and qualitative nature (the presence of ketonemia/ketonuria). A new method is now available to measure capillary levels of beta-hydroxybutyrate (beta -0HB), It is a quantitative and enzymatic test that uses the same equipment as for home capillary blood glucose determination but with specific strips. Aim of the work: The aim of this study was to evaluate the use of measurement of capillary B-hydroxybutyrate (beta-OHB) during the diagnosis and follow up of type 1 diabetic patients with DKA.

Subjects and Methods: This study was conducted on 40 type 1 diabetic patients presented to (NIDE) with DKA and who were aged 4–20 years and half of them was males. 140 capillary blood samples were tested for beta-hydroxybutyrate using blood beta-OHB test strips. Measurement of serum bicarbonatre (HCO3), blood glucose and urine acetone and estimation of venous blood pH and anion gap had been done for all patients.

Results: Linear regression revealed highly significant correlation between capillary β-OHB levels and all indices of acidosis but no significant correlation between acetone in urine and serum bicarbonate. Using regression to predict values of HCO3, pH and anion gap from β-OHB levels revealed that levels of β-OHB of 1.4, 1.9, 2.7,3.5 and 4.0 mmol/l corresponded to HCO3 levels of >18, 15–18, 10-<15, 5-<10 mEq/l.

Conclusions: The measurement of capillary β-OHB levels is easy and give rapid and objective results. Capillary β-OHB levels are more predictable than urinary acetone for degrees of acidosis and severity of DKA and can be used at diagnose and follow up of type1 diabetic patients with DKA to improve their management.

Key words: Acetoacetic acid (ACAC) B-hydroxybutyrate (β-OHB) Diabetic Ketoacidosis (DKA) bicarbonate (HCO3) and National Institute of Diabetes & Endocrinology, (NIDE).

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector