Metabolic Disturbances that Lead to ß-hydroxybutyrate and Ketone Bodies
Dr. James H. Nichols
Wednesday, January 2, 2013
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Chapters
Introduction
Disclosures
Objectives
Glucose Facts!
Insulin
Before and After
Adipose Tissue Stores Energy
Fats to the Rescue
Fuel Glucose – Fed & Fasting
What is Diabetes Mellitus?
Diabetes Mellitus
Insulin Deficiency
Significance of Ketone Bodies
Diabetic Ketoacidosis
DKA Epidemiology
Number of hospital discharges with DKA
Clinical Presentation
Typical Case
Etiology
Pathogenesis
Pathogenesis, cont.
Case #1
Case #2
Case #3
Ketone Bodies
Diabetic Ketoacidosis
Absence of Insulin Allow Catabolic/ Gluconeogenic Hormones to Exert Influence
Ketone Bodies
Nitroprusside Reaction
Ketone Bodies
βHB Methodologies
βOHB Quantitation
Ketone Testing Recommendations
Other Causes of Ketoacidosis
βOHB...Other Uses?
Glucose Level & Glucose, POC
DKA Glucose Meter Interference
DKA Glucose Meter Interference: Methods
DKA Glucose Meter Interference: Demographics
POC vs Lab Glucose in DKA
Blood Glucose Measurement in Patients with Suspected Diabetic Ketoacidosis
Ketogenic Diets
The Ketogenic Diet and Seizure Control
The Ketogenic Diet
Other Potential Future βOHB Uses?
Dietary Monitoring: The Future?
Case #1
Case #2
Case #3
Summary
Question #1
Question #2
Question #3
Question #4
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