In patients with severe insulin deficiency, glucose utilization in the body is impaired, and the body can only produce the energy required for life by extensively mobilizing fat tissues. Due to insulin deficiency, intermediate metabolic products such as acetone, acetic acid, and β-hydroxybutyric acid can be produced, which are collectively referred to as ketone bodies. These substances are generally acidic, and excessive accumulation can lead to ketoacidosis. Additionally, during fasting, the body increases fat mobilization and decomposition due to reduced or absent usable glucose, also producing small amounts of ketone bodies, referred to as fasting ketones.
1.Uric ketone body determination:
Ketone bodies in the blood are filtered into the urine by the kidneys, which are called urinary ketone bodies. Normally, urinary ketone bodies are qualitative as negative, and the total amount of urinary ketone bodies (measured in acetone) is 20-50mg in 24 hours. When ketoacidosis occurs, urinary ketone bodies are positive, referred to as ketonuria. The positive status of urinary ketone bodies does not correspond to that of urinary glucose.
2.Blood ketone body determination:
Normal blood ketone bodies are negative, and the blood ketone body concentration (measured in acetone) is less than 0.05mmol/L. Most of these ketone bodies are transported to the kidneys and muscle tissues via the blood circulation for oxidation and utilization, thus not accumulating as ketonemia or causing ketoacidosis. For diabetic patients, monitoring blood ketone bodies is beneficial for early diagnosis of diabetic ketoacidosis. A positive blood ketone body test with a concentration greater than 5mmol/L indicates the presence of ketoacidosis or ketoacidosis.
Other commonly used laboratory examination indicators:
- Urine: Routine testing of protein qualification, white blood cells, red blood cells, and other indicators should be performed. This helps to detect and treat various complications and combined diseases early, such as urinary tract infections, kidney disease, etc.
- Blood: Testing of blood biochemical indicators, blood lipids, lipoproteins, and hemorheological indicators. Monitoring these indicators is beneficial for preventing and controlling cardiovascular and neurological complications, as well as detecting acute metabolic complications early. Additionally, detecting insulin antibodies, insulin receptor antibodies, and islet cell antibodies in the blood helps to explain changes in the condition and has certain clinical value. Insulin receptor antibodies and islet cell antibody testing are rarely used in clinical practice.
