TY - JOUR T1 - Use of capillary ketones monitoring in treatment of mild ketotic crisis in people with ketosis-prone atypical diabetes JF - Journal of Investigative Medicine JO - J Investig Med SP - 1193 LP - 1195 DO - 10.1136/jim-2019-001267 VL - 68 IS - 6 AU - Eugene Sobngwi AU - Christine Ghislaine G Ngo Ngai AU - Martine Etoa Etoga AU - Eric Lontchi-Yimagou AU - Armand Mbanya AU - Mesmin Dehayem AU - Jean-Claude Mbanya Y1 - 2020/08/01 UR - http://hw-f5-jim.highwire.org/content/68/6/1193.abstract N2 - 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. ER -