Authors: R. Pazdírková; V. Rákosníková; Š. Průhová; J. Lebl Authors‘ workplace: Klinika dětí a dorostu 3. LF UK a FN Královské Vinohrady, Praha přednosta doc. MUDr. J. Lebl, CSc. Published in: Čes-slov Pediat 2003; (5): 274-277. Category:
Diabetic ketoacidosis (DKA) is a major cause of mortality of children with diabetes mellitus even in developedcountries (mortality 1 - 2 %). Bedside laboratory estimations contribute to its more sophisticated therapy. Up tonow, bedside monitoring of ketogenesis has been limited to urine dipstick tests based on the nitroprusside reaction(Ketophan, Diaphan). This semiquantitative estimation detects acetoacetate but not beta-hydroxybutyrate (-OHB) which is the predominant ketone body responsible for acidosis. Authors tested 17 patients (7 boys) age 0.1 -17.4 years (median 10.7) during initial treatment of newly diagnosed type 1 diabetes mellitus or during therapy ofDKA which appeared later in the course of diabetes. Forty-three -OHB estimations (using bedside system withelectrochemical sensor - Optium, Abbot/Medisense) were correlated with parallel results of acid-base balance andwith semiquantitative measurement of ketonuria (Diaphan). Levels of -OHB ranged from 0.0 to 5.7 mmol/L(median 0.8). A significant correlation was found between -OHB and pH (r = -0.62, p
Key words: type 1 diabetes mellitus, diabetic ketoacidosis, children, ketogenesis, beta-hydroxybutyrate
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