Evidence map›Paper›PMID 36794812›Full record

ReviewJournal of diabetes science and technology2024

Update on Measuring Ketones.

Jingtong Huang, Andrea M Yeung, Richard M Bergenstal, Kristin Castorino, Eda Cengiz, Ketan Dhatariya, Isabella Niu, Jennifer L Sherr, Guillermo E Umpierrez, David C Klonoff

2 registry-linked trialsOpen access · greenAbstract readReview
In one paragraph

Review in Journal of diabetes science and technology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
6.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07325201 phase2not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Mitigating Diabetic Ketoacidosis in People With T1D and Chronic Kidney Disease on an SGLT1&2 Inhibitor: Ketosis Risk Factor Determination and Incorporation Into an Enhanced Glucose Ketone Report

TypeinterventionalSponsorHealthPartners InstituteRan2026 to 2030Enrolled80ConditionsType 1 Diabetes Mellitus, Chronic Kidney Disease (CKD) With Diabetes Mellitus (DM), Chronic Kidney Disease, Diabetic KetoacidosisArmsSotagliflozin initiation
NCT07495267 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Nutritional Ketosis as a Novel Therapeutic Strategy to Stabilize Chronic Aortic Dissection in Marfan Syndrome

TypeinterventionalSponsorWashington University School of MedicineRan2026 to 2028Enrolled15ConditionsMarfan Syndrome, Aortic DissectionArmsKetogenic diet
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
  5. Article
  6. Isopropanol toxicity.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
  7. Article
  8. Euglycemic Diabetic Ketoacidosis: Clinical Suspicion and Diagnosis.Clinical medicine insights. Endocrinology and diabetes · 2026
    Review
  9. Review
  10. Review
  11. Article
  12. Glycemic Management in Adults With Diabetes During Illness.Clinical diabetes : a publication of the American Diabetes Association · 2025
    Article
  13. Observational
  14. Article
  15. Review
  16. Article
  17. Review
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 2 countries.

Jingtong HuangDiabetes Technology Society, Burlingame, CA, USA.ORCID 0000-0002-3119-9361
Andrea M YeungDiabetes Technology Society, Burlingame, CA, USA.ORCID 0000-0002-5592-453X
Richard M BergenstalInternational Diabetes Center, HealthPartners Institute, Minneapolis, MN, USA.ORCID 0000-0002-9050-5584
Kristin CastorinoSansum Diabetes Research Institute, Santa Barbara, CA, USA.ORCID 0000-0001-6386-9203
Eda CengizUniversity of California San Francisco, San Francisco, CA, USA.ORCID 0000-0001-7992-9506
Ketan DhatariyaNorfolk and Norwich University Hospitals NHS Foundation Trust and Norwich Medical School, University of East Anglia, Norfolk, UK.ORCID 0000-0003-3619-9579
Isabella NiuUniversity of California San Francisco, San Francisco, CA, USA.ORCID 0000-0002-7190-079X
Jennifer L SherrYale University, New Haven, CT, USA.ORCID 0000-0001-9301-3043
Guillermo E UmpierrezEmory University School of Medicine, Atlanta, GA, USA.ORCID 0000-0002-3252-5026
David C KlonoffDiabetes Technology Society, Burlingame, CA, USA.ORCID 0000-0001-6394-6862
Diabetes Technology Society · USUniversity of California, San Francisco · USEmory University · USHealthPartners · USMills Peninsula Health Services · USSansum Diabetes Research Institute · USUniversity of East Anglia · GBYale University · US

Funding

Translational Research Core - Engagement and Behavior ChangeP30DK111024 · NIDDK · EMORY UNIVERSITY · PI Mohammed Kumail Ali · 2016 to 2026
$13.4M
Training Program in Pediatric EndocrinologyT32DK007161 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Brian J Feldman, STEPHEN E GITELMAN · 1986 to 2026
$6.2M
NIDDK NIH HHS P30 DK111024NIDDK NIH HHS T32 DK007161
6 · The paper itself

Abstract

Ketone bodies are an energy substrate produced by the liver and used during states of low carbohydrate availability, such as fasting or prolonged exercise. High ketone concentrations can be present with insulin insufficiency and are a key finding in diabetic ketoacidosis (DKA). During states of insulin deficiency, lipolysis increases and a flood of circulating free fatty acids is converted in the liver into ketone bodies-mainly beta-hydroxybutyrate and acetoacetate. During DKA, beta-hydroxybutyrate is the predominant ketone in blood. As DKA resolves, beta-hydroxybutyrate is oxidized to acetoacetate, which is the predominant ketone in the urine. Because of this lag, a urine ketone test might be increasing even as DKA is resolving. Point-of-care tests are available for self-testing of blood ketones and urine ketones through measurement of beta-hydroxybutyrate and acetoacetate and are cleared by the US Food and Drug Administration (FDA). Acetone forms through spontaneous decarboxylation of acetoacetate and can be measured in exhaled breath, but currently no device is FDA-cleared for this purpose. Recently, technology has been announced for measuring beta-hydroxybutyrate in interstitial fluid. Measurement of ketones can be helpful to assess compliance with low carbohydrate diets; assessment of acidosis associated with alcohol use, in conjunction with SGLT2 inhibitors and immune checkpoint inhibitor therapy, both of which can increase the risk of DKA; and to identify DKA due to insulin deficiency. This article reviews the challenges and shortcomings of ketone testing in diabetes treatment and summarizes emerging trends in the measurement of ketones in the blood, urine, breath, and interstitial fluid.

Indexed as

Diabetic KetoacidosisKetones3-Hydroxybutyric AcidAcetoacetatesBreath TestsHumansKetone BodiesPoint-of-Care Testing3-Hydroxybutyric AcidAcetoacetatesKetone BodiesKetonescontinuous ketone monitordiabetesdiabetic ketoacidosisinsulinketonesSGLT2 inhibitors

Identifiers

PMID36794812
PMCPMC11089855
OpenAlexW4321002074

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.