Proceedings of The 3rd Africa Diabetes Congress, Yaounde, Cameroon (Yaounde, 2017)

Oral presentation

Use of capillary ketones monitoring in treatment of mild ketotic crisis in adults with ketosis prone atypical diabetes

Cite this: Pan African Medical Journal - Conference Proceedings. Aug 2017; 2(2): 17. doi:10.11604/pamj.cp.2017.2.17.47

Submitted: 31 Aug 17   Accepted: 31 Aug 17   Published: 31 Aug 17

Key words: Ketosis-pronratypical diabetes, ketonuria, ketonemia

© Christine Ngo Ngai et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.proceedings.panafrican-med-journal.com/conferences/2017/2/17/abstract

Corresponding author: (cgngai@gmail.com)

This abstract is published as part of the proceedings of The 3rd Africa Diabetes Congress, Yaounde, Cameroon(CAMEROON, )

Untitled Document

Use of capillary ketones monitoring in treatment of mild ketotic crisis in adults with ketosis prone atypical diabetes

Christine Ngo Ngai1,&, Eugene Sobngwi1,2,3, Eric Lontchi-Yimagou2,4, Armand Mbanya1,4, Mesmin Dehayem1,3, Martine Etoa Etoga1, Jean-Claude Mbanya1,2,3

 

1National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon, 2Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon, 3Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon, 4Diabetes Research and Training Center, Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York

 

 

&Corresponding author
Christine Ngo Ngai, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon

 

 

Abstract

Introduction: the utility of capillary ketones monitoring is known in the management of type 1 diabetes and severe diabetic ketoacidosis, but not in adults with ketosis-prone atypical diabetes (KPD) or mild ketosis. The objective was to assess the potential reduction in duration of intensive diabetic ketoacidosis treatment in adults with KPD when using capillary versus urinary ketones.

 

Methods: from February to end March 2015, a total of 20 (9/20 newly diagnosed) patients, aged 46 ± 12 years and classified as KPD presented at the National Obesity Center of the Yaoundé Central Hospital with marked hyperglycemia and significant ketosis (ketonuria ≥ ++) requiring intensive insulin treatment.. The mean plasma glucose and urinary ketones levelon admission was 22.8 ± 5mmol/L and 2.9± 2.7 mmol/L respectively. No patient had severe acidosis (HCO3 < 14mmol/L). Intensive insulin treatment was initiated at 10 UI per hour with concomitant measurement of capillary and urinary ketones every 2 hours until the absence of ketonuria. Capillary beta-hydroxybutyrate levels were measured by an electrochemical method (MediSenseOptium meter). Ketonuria was measured by a semi quantitative test (Ketodiastix). Time-to-disappearance of urine ketones was compared to the time-to-normalization of capillary ß-hydroxybutyrate concentrations (< 0.5mmol/L).

 

Results: the time-to-normalization of ketonuria ranged between 2 and 14 hours, and that of ketonemia between 1 and 10 hours. The mean time-to-disappearance of ketonuria was 6.3 ± 3.6 hours with a median time of 5 hours, while the mean time-to-normalization of capillary β-hydroxybutyrate was 4.2 ± 2.7 hours with the median of 4 hours (p = 0.0002). The absolute difference in time-to-normalization of ketonuria versus ketonemia was 2[1-3] hours (median [interquartile difference]) and relative time reduction of treatment to 32.5 ± 18.0%.

 

Conclusion: the use of capillary ketones versus ketonuria would allow a significant reduction in duration of intensive insulin treatment by one third in adults with ketosis prone diabetes and therefore reduce admission rates and costs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The 3rd Africa Diabetes Congress, Yaounde, Cameroon (Yaounde)

Country: CAMEROON

Dates: 19 Apr 17 - 22 Apr 17

Venue: Yaounde Congress Hall

Organizers: Africa Diabetes Congress Limited

Secretariat: secretariat@africadiabetescongress.com

Contact person: Prof. Jean Claude Mbanya (jcmbanya@yahoo.co.uk)