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Aboott produce a hand held sensor that measures B hydroxybutyrate electrochemically in 30 seconds.
As I understand it, Abbott are supplying the strips free of charge at the moment to some Diabetes Nurses in the UK to assess development of ketosis in Type 1 Diabetics in the community. (The strips aren't available yet on prescription.) As far as I know the strips aren't in use in hospital A/E Depts but I would be interested to know if I am wrong. One of our diabetes nurses is keen to use them on selected patients (in a 'research' type way) and I have looked at some literature sent via Abbott for her. Analytically the meter seems OK, and probably wouldn't do any harm, but I think the jury is out whether it actually helps manage patients over conventional measurements (pH, CO2, etc.) in the acute or situation, or is in practice likely to manage patients in the community better. The meter/strips do have an advantage over urine ketone measurement in being sensitive to B HBA.
The recent AACC 'Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus' recently published (Clin Chem 2002; 436-472) has a section on the use of ketones and in summary states there is lack of evidence for blood ketone measurement and suggests further studies. They also state urine ketone measurements should not be used to diagnose or monitor the course of DKA and for blood prefer methods that are more specific to BHBA than nitroprusside reaction, but again suggest further studies.
References I have on to hand on the meter are, Byrne HA et al. Diabetes Care,2000, 23; 4, 500-503 and Wallace, TM et al. Diabetes Medicine 2001, 18; 640-645.
Regards
Steve Frost
Dr Stephen Frost
Clinical Scientist
The Princess Royal Hospital
Haywards Heath
West Sussex
-----Original Message-----
From: Mohammad Al-Jubouri [mailto:[log in to unmask]]
Sent: Wednesday, May 22, 2002 9:46 AM
To: [log in to unmask]
Subject: Blood ketone meter
Hi
Any body has experience with the use of the above.
Does it provide any useful extra information for
diagnosis and management of DKA over and above blood
glucose and urine ketones testing?
Mohammad
=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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