This view is very much supported by the ketones chapter of the recently issued NACB guideline and what the references cited in its evidence table refer to.
The guideline can be downloaded from NACB's home page (http://www.aacc.org/members/nacb/LMPG/Pages/default.aspx)
Regards, Rita
Prof. Andrea Rita Horvath
Clinical Director
SEALS North, Department of Clinical Chemistry
Level 4, Campus Centre, Prince of Wales Hospital
Barker Street, Randwick, NSW 2031, Sydney, Australia
Tel: (+612)-9382 9078
Fax: (+612)-9382 9099
Mobile No: (+61)-404 027 843.
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OKane, Maurice
Sent: Monday, 5 September 2011 11:21 PM
To: [log in to unmask]
Subject: Re: Blood ketone testing
This e-mail is covered by the disclaimer found at the end of the message.
Wayne
Although there have been a few small studies, there is no robust evidence that home ketone testing has any impact on DKA rates. I think this would actually be very difficult to show, as DKA has a relatively infrequent event rate per patient per year and would therefore require large, longish term studies. More importantly, any sort of home testing like this as part of a self management package represents a complex intervention and it is very difficult to eliminate confounding e.g. patients who perform appropriate ketone self monitoring are likely to be good at other aspects of self management also etc etc.
We provide POCT ketone testing to limited clinical areas within the hospital. There is some evidence for the role of ketone measurement in the treatment of DKA.
Best wishes
Maurice
Dr Maurice O'Kane
Consultant Chemical Pathologist
Altnagelvin hospital
Western Health and Social Care Trust
Londonderry
N. Ireland
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Bradbury Wayne (RNL) North Cumbria University Hospitals
Sent: 05 September 2011 12:36
To: [log in to unmask]
Subject: Blood ketone testing
Hello all,
We are in the process of rolling out PoCT meters to test for beta-hydroxy butyrate on a
limited number of wards for patients with DKA. This will help our Trust comply with the
guideline published last year by the Joint British Diabetes Societies. See this link.....
http://www.diabetes.nhs.uk/document.php?o=1336
Our pharmacy dept. are concerned about the costs of this development, as they pay
for the test strips which are approximately £2 each.
An associated issue is the practice of meter companies supplying free meters to patients
for use at home on the basis that this will reduce DKA admissions. Is this true?
I guess most of you already provide, or are planning to introduce PoCT but have any of you
decided not to go down this route and only provide testing from the lab on either your main
analytical platform or by using a meter?
Alternatively have any of you looked at this issue and decided not to provide blood ketone
testing at all?
Please reply to the list or, if you want anonymity and I receive more than a couple of replies
I'll collate them and post back to the list by the end of the week.
Thanks,
Wayne.
Mr WH Bradbury
Consultant Biochemist
Biochemistry Department
Cumberland Infirmary
CARLISLE
Cumbria
CA2 7HY
Tel: 01228 814521
Fax: 01228 814831
E-mail: [log in to unmask] <mailto:[log in to unmask]>
------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
This email is confidential and intended solely for the use of the individual to whom it is addressed. Any views or opinions presented are solely those of the author and do not necessarily represent the views of the Trust or organisation it was sent from.
If you are not the intended recipient, be advised that you have received this email in error and that any use, dissemination, forwarding, printing, or copying of this email is strictly prohibited.
If you have received this email in error please contact the sender.
The content of this e-mail and any attachments or replies may be subject to public disclosure under the Freedom of Information Act 2000, unless legally exempt.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
---------------------------------------------------------------------------------------------
Illawarra Shoalhaven Local Health District, South East Sydney Local Health District and Sydney Children's Hospital Network (Randwick Campus) Confidentiality Notice
This email, and the files transmitted with it, are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, you are not permitted to distribute or use this email or any of its attachments in any way. We also request that you advise the sender of the incorrect addressing.
This email message has been virus-scanned. Although no computer viruses were detected, Illawarra Shoalhaven Local Health District, South East Sydney Local Health District and Sydney Children's Hospital Network (Randwick Campus) accept no liability for any consequential damage resulting from email containing any computer viruses.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|
