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This table provides a structured overview of blood ketone level interpretation and its implications in managing diabetes, especially in distinguishing ketoacidosis.
Measurement indications
| Term/Concept | Description/Interpretation |
|---|---|
| Ketones | Organic compounds formed when body fat breaks down for energy. Can cause toxicity when produced excessively due to lack of insulin. |
| Diabetic Ketoacidosis (DKA) | Accumulation of ketones in the blood of diabetes mellitus patients, leading to metabolic acidosis. |
| When to Measure Blood Ketones | |
| Diagnosis of DKA | Establish the presence of DKA. |
| Treatment of DKA | During the management of confirmed DKA. |
| Acutely unwell diabetic patient | Particularly when capillary blood glucose >18mmol/l. |
| Fasting type 1 diabetic | Measure daily. |
| Persistently unwell patient | For symptoms like systemic illness, infection, fever, nausea, diarrhoea, or post fasting. |
| Risk of new-onset DKA/Type 1 | Especially in acutely unwell patients, including those with covid-19. |
| Special Considerations | |
| Taking SGLT-2 inhibitors or acutely unwell with COVID-19 | Risk of euglycaemic DKA. Blood glucose may be normal/slightly raised; don't rely solely on glucose levels for DKA diagnosis in these cases. |
| Acutely unwell Type 2 diabetic | Test blood ketones as part of the initial assessment. |
Interpretation
| Situation/Condition | Guidance/Interpretation |
|---|---|
| Testing Indication | To differentiate ketoacidosis from simple hyperglycaemia or monitor DKA response. Test capillary glucose and blood ketone levels every... |
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