ArticleDiabetes care2011
Diagnostic accuracy of point-of-care testing for diabetic ketoacidosis at emergency-department triage: {beta}-hydroxybutyrate versus the urine dipstick.
Article in Diabetes care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Efficacy of Ketogenic Therapies in the Clinical Management of People with Neurodegenerative Disease: A Systematic Review.Advances in nutrition (Bethesda, Md.) · 2021Pooled it
- Evaluation of the Accuracy of Capillary Hydroxybutyrate Measurement Compared with Other Measurements in the Diagnosis of Diabetic Ketoacidosis: A Systematic Review.International journal of environmental research and public health · 2016Pooled it
- The Practice Guidelines for Primary Care of Acute Abdomen 2015.Japanese journal of radiology · 2016Guideline
- Low-fat versus ketogenic diet in Parkinson's disease: A pilot randomized controlled trial.Movement disorders : official journal of the Movement Disorder Society · 2018Trial
- A review of capillary β-hydroxybutyrate cut-off levels for the exclusion and identification of diabetic ketoacidosis.Journal of diabetes investigation · 2026Review
- Beyond GLP-1 Agonists: An Adaptive Ketogenic-Mediterranean Protocol to Counter Metabolic Adaptation in Obesity Management.Nutrients · 2025Review
- Screening and management of hospital hyperglycemia in non-critical patients: a position statement from the Brazilian Diabetes Society (SBD).Diabetology & metabolic syndrome · 2025Review
- The role of β-hydroxybutyrate testing in ketogenic metabolic therapies.Frontiers in nutrition · 2025Review
- A Case of Euglycemic Diabetic Ketoacidosis Associated With a Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor.Cureus · 2024Article
- Continuous ketone monitoring: Exciting implications for clinical practice.Diabetes, obesity & metabolism · 2024Review
- Serum 3-Hydroxybutyrate is Expected to Serve as One of the Supportive Diagnostic Markers of Persistent Idiopathic Dentoalveolar Pain (PDAP).Journal of pain research · 2023Article
- Serum ketone body measurement in patients with diabetic ketoacidosis.Diabetology international · 2022Article
- Potential Clinical Applications for Continuous Ketone Monitoring in the Hospitalized Patient with Diabetes.Current diabetes reports · 2022Review
- Controversies Around the Measurement of Blood Ketones to Diagnose and Manage Diabetic Ketoacidosis.Diabetes care · 2022Review
- The burden of diabetic emergencies on the resuscitation area of a district-level public hospital in Cape Town.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2021Article
- Serum 3-Hydroxybutyrate in Patients with Psychogenic Somatoform Symptoms May Be a Predictor of the Effectiveness of Sertraline and Venlafaxine.International journal of general medicine · 2021Article
- Urine dipsticks are not accurate for detecting mild ketosis during a severely energy restricted diet.Obesity science & practice · 2020Article
- Altered Metabolome of Lipids and Amino Acids Species: A Source of Early Signature Biomarkers of T2DM.Journal of clinical medicine · 2020Review
- Current and emerging trends in point-of-care urinalysis tests.Expert review of molecular diagnostics · 2020Review
- Diagnosis and management of metabolic acidosis: guidelines from a French expert panel.Annals of intensive care · 2019Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn the emergency department, hyperglycemic patients are screened for diabetic ketoacidosis (DKA) via a urine dipstick. In this prospective study, we compared the test characteristics of point-of-care β-hydroxybutyrate (β-OHB) analysis with the urine dipstick. RESEARCH DESIGN AND
methodsEmergency-department patients with blood glucose ≥250 mg/dL had urine dipstick, chemistry panel, venous blood gas, and capillary β-OHB measurements. DKA was diagnosed according to American Diabetes Association criteria.
resultsOf 516 hyperglycemic subjects, 54 had DKA. The urine dipstick had a sensitivity of 98.1% (95% CI 90.1-100), a specificity of 35.1% (30.7-39.6), a positive predictive value of 15% (11.5-19.2), and a negative predictive value of 99.4% (96.6-100) for DKA. Using the manufacturer-suggested cutoff of >1.5 mmol/L, β-OHB had a sensitivity of 98.1% (90.1-100), a specificity of 78.6% (74.5-82.2), a positive predictive value of 34.9% (27.3-43), and a negative predictive value of 99.7% (98.5-100) for DKA.
conclusionsPoint-of-care β-OHB and the urine dipstick are equally sensitive for detecting DKA (98.1%). However, β-OHB is more specific (78.6 vs. 35.1%), offering the potential to significantly reduce unnecessary DKA work-ups among hyperglycemic patients in the emergency department.
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