The diagnosis of diabetic acute complications using the glucose-ketone meter in outpatients at endocrinology department

Objective: To determine urine ketone and blood β-hydroxybutyrate acid (β-HBA) in outpatients of endocrinology department and to investigate the association between urine ketone or blood β-HBA and diabetic ketosis (DK) or diabetic ketoacidosis (DKA).

Methods: Urine ketone, blood β-HBA, body mass index (BMI) and glycosylated hemoglobin (HbA1c) were determined in 134 patients with blood glucose ≥ 13.9 mmol/L.

Results: In 134 patients with severe hyperglycemia, there were 30 patients (22.4%) with acute complications of diabetes, including 24 patients (17.9%) diagnosed with DK and 6 patients (4.5%) diagnosed with DKA. Among them, 6 patients (20%) were withdrawal, 2 (6.7%) were infected, and 19 (63.3%) were not treated. When there was a negative urine ketone, 10% patients would have had blood β-HBA ≥ 0.3 mmol/L. When there was a positive urine ketone (+ to +++), 22.62% patients would have had blood β-HBA < 0.3 mmol/L.

Conclusions: Blood β-HBA had a positive correlation with blood glucose (r = 0.34, P < 0.001). Complications of severe hyperglycemia could be diagnosed quickly and accurately by analyzing blood β-HBA using the glucose-ketone meter.