PT  - JOURNAL ARTICLE
AU  - Puntip Tantiwong
AU  - Gobchai Puavilai
AU  - Boonsong Ongphiphadhanakul
AU  - Pongamorn Bunnag
AU  - Chardpraorn Ngarmukos
TI  - Capillary Blood Beta-Hydroxybutyrate Measurement by Reagent Strip in Diagnosing Diabetic Ketoacidosis
AID  - 10.29074/ascls.18.3.139
DP  - 2005 Jul 01
TA  - American Society for Clinical Laboratory Science
PG  - 139--144
VI  - 18
IP  - 3
4099  - http://hwmaint.clsjournal.ascls.org/content/18/3/139.short
4100  - http://hwmaint.clsjournal.ascls.org/content/18/3/139.full
SO  - Clin Lab Sci2005 Jul 01; 18
AB  - OBJECTIVE: To compare blood beta-hydroxybutyrate (β-OHB) levels measured by reagent strip with serum ketone levels assessed by the nitroprusside reaction in diagnosing diabetic ketoacidosis (DKA).DESIGN: Prospective study of DKA in 19 Thai diabetic patients from September 2001 until August 2002.SETTING: A university hospital.PATIENTS: Nineteen patients with DKA and ten patients with metabolic acidosis from other causes.INTERVENTIONS: Capillary blood β-OHB was measured by a blood ketone meter (MediSense® Optium™). Concurrently, serum ketone was measured semiquantitatively by nitroprusside reaction (Ketostix®, N-multistix®, and Labstix®).MAIN OUTCOME MEASURE: Sensitivity, specificity, and ROC curve of both methods in diagnosing DKA.RESULT: Mean age ± SD of DKA patients was 45.6 ± 16.95 years. Plasma glucose was 675.25 ± 188.15 mg/dL, arterial blood pH 7.19 ± 0.12, anion gap and serum bicarbonate 29.93 ± 4.90 and 8 ± 3.35 mmol/L. Serum ketone was moderately to markedly positive in most cases. Capillary β-OHB ranged from 2.4 to >6 mmol/L. The sensitivity and specificity of serum ketone by nitroprusside reaction in diagnosing DKA were 95% and 100%. The sensitivity and specificity of capillary β-OHB was 90% and 100% respectively. The areas under ROC curves of serum ketone and capillary β-OHB were 0.975 and 0.950 (NS) respectively.CONCLUSION: Serum ketone and blood β-OHB measurement are equally effective in diagnosing DKA among uncomplicated cases.ABBREVIATIONS: β-OHB = beta-hydroxybutyrate; DKA = diabetic ketoacidosis; MA = metabolic acidosis; ROC = receiver operating characteristic.