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Case Studies of Ketosis and the Clinical Utility of -Hydroxybutyrate

Levy, Rebecca A. MD*; Gordner, Chelsea DO; Nichols, James H. PhD*

Point of Care: The Journal of Near-Patient Testing & Technology:
doi: 10.1097/POC.0b013e3182a178b4
Case Report

Abstract: Three case studies are described for patients presenting with ketosis. Patients have medical histories of type 1 diabetes and type 2 diabetes. These patients present with elevated blood and urine ketones associated with diabetic ketoacidosis (DKA), alcoholic ketosis, and starvation-induced ketosis with a possible component of DKA. The metabolism of ketones and the physiology of DKA are described, and the various laboratory methodologies for analyzing blood and urine ketone bodies are also reviewed.

Author Information

From the Departments of *Pathology and †Adult and Pediatric Endocrinology, Baystate Medical Center, Springfield, MA.

Reprints: James Nichols, PhD, Baystate Health, Springfield, MA. E-mail:

The authors declare no conflict of interest.

© 2013 by Lippincott Williams & Wilkins