Use of capillary ketones monitoring in treatment of mild ketotic crisis in people with ketosis-prone atypical diabetes

Eugene Sobngwi, Christine Ghislaine G. Ngo Ngai, Martine Etoa Etoga, Eric Lontchi-Yimagou, Armand Mbanya, Mesmin Dehayem, Jean Claude Mbanya

Research output: Contribution to journalArticlepeer-review

Abstract

This study was carried out to assess the potential reduction in duration of intensive diabetic ketoacidosis treatment in adults with ketosis-prone atypical diabetes (KPD) when using capillary versus urinary ketones. In this cross-sectional study, we included 20 people with KPD presented at the National Obesity Center of the Yaoundé Central Hospital with hyperglycemic decompensation (random capillary glucose ≥13 mmol/L) and significant ketosis (ketonuria≥++) requiring intensive insulin treatment. In all subjects, intensive insulin treatment was initiated at 10 UI per hour with simultaneous measurement of capillary beta-hydroxybutyrate and ketonuria every 2 hours until disappearance of ketonuria. Time-to-disappearance of urine ketones was compared with the time-to-normalization of capillary β-hydroxybutyrate concentrations. Subjects were aged 46±13 years with a median duration of diabetes of 1.5 (IQR: 0-2.5) years. On admission, the mean blood glucose was 22.8±5 mmol/L and capillary ketones level was 2.9±2.7 mmol/L. The median time-to-disappearance of ketonuria was 5 (IQR: 3-8) hours compared with the time-to-normalization of capillary β-hydroxybutyrate of 4 (IQR: 2-6) hours, p=0.0002. The absolute difference in time-to-normalization of ketonuria versus ketonemia was 2 (IQR: 1-3) hours and the relative time reduction of treatment was 32.5±18.0. Our results suggested that the use of capillary ketones versus ketonuria would allow a significant reduction in duration of intensive insulin treatment by one third in people with KPD.

Original languageEnglish (US)
Pages (from-to)1193-1195
Number of pages3
JournalJournal of Investigative Medicine
Volume68
Issue number6
DOIs
StatePublished - Aug 1 2020

Keywords

  • diabetes complications
  • diabetes mellitus
  • disease management

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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