Method comparison of beta‐hydroxybutyrate point‐of‐care testing to serum in healthy children

Parmar, Komalben; Mosha, Maua; Weinstein, David A.; Riba-Wolman, Rebecca

doi:10.1002/jmd2.12245

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…Most studies provide BHB concentrations after prolonged fasting, but recently, Parmar et al. demonstrated that serum point-of-care (POCT) BHB measurement using a precision Xtra meter are comparable to serum BHB concentrations in healthy children after an overnight fast ( 51 ). In 94 children (age range 6 months to 18.7 years) scheduled to undergo elective surgery, POCT BHB concentrations ranged from 0 to 1.1 mmol/l, but unfortunately, detailed information on the correlation between age and BHB concentrations was not provided in their study.…”

Section: In Vivo Metabolic Profiling By Continuous Glucose M...mentioning

confidence: 99%

Dynamic Methods for Childhood Hypoglycemia Phenotyping: A Narrative Review

Rossi

Rutten²,

Dijk³

et al. 2022

Front. Endocrinol.

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Hypoglycemia results from an imbalance between glucose entering the blood compartment and glucose demand, caused by a defect in the mechanisms regulating postprandial glucose homeostasis. Hypoglycemia represents one of the most common metabolic emergencies in childhood, potentially leading to serious neurologic sequelae, including death. Therefore, appropriate investigation of its specific etiology is paramount to provide adequate diagnosis, specific therapy and prevent its recurrence. In the absence of critical samples for biochemical studies, etiological assessment of children with hypoglycemia may include dynamic methods, such as in vivo functional tests, and continuous glucose monitoring. By providing detailed information on actual glucose fluxes in vivo, proof-of-concept studies have illustrated the potential (clinical) application of dynamic stable isotope techniques to define biochemical and clinical phenotypes of inherited metabolic diseases associated with hypoglycemia. According to the textbooks, individuals with glycogen storage disease type I (GSD I) display the most severe hypoglycemia/fasting intolerance. In this review, three dynamic methods are discussed which may be considered during both diagnostic work-up and monitoring of children with hypoglycemia: 1) functional in vivo tests; 2) in vivo metabolic profiling by continuous glucose monitoring (CGM); 3) stable isotope techniques. Future applications and benefits of dynamic methods in children with hypoglycemia are also discussed.

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Section: In Vivo Metabolic Profiling By Continuous Glucose M...mentioning

confidence: 99%

Dynamic Methods for Childhood Hypoglycemia Phenotyping: A Narrative Review

Rossi

Rutten²,

Dijk³

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

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Method comparison of beta‐hydroxybutyrate point‐of‐care testing to serum in healthy children

et al. 2021

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Ketone production is a physiological phenomenon that occurs to avoid irreversible neurological damage from hypoglycemia, thereby serving as a marker of metabolic stress. The primary ketone body, beta‐hydroxybutyrate (BHB), guides the diagnostic evaluation and management of many hypoglycemic disorders. Serum and point‐of‐care (POC) BHB values were not been compared in children without diabetes or metabolic disorders. We aim at comparing the serum and point‐of‐care BHB values in healthy children after an overnight fast. Eligible participants were ≤18 years of age prospectively recruited from elective procedures through our surgery centers. Exclusion criteria included a history of diabetes, hypopituitarism, adrenal, metabolic or inflammatory disorders, dietary restrictions, trauma, or use of medications that might affect blood glucose. The main outcome measure was comparing serum and POC BHB levels after a period of fasting. Data from 94 participants (mean age 8.29 ± 5.68 years, 54.3% male, 45.7% female, BMI mean 19.28 ± 5.25 kg/m2) were analyzed. There was a strong correlation between serum BHB (mean 0.25 ± 0.23 mmol/L) and POC BHB (mean 0.18 ± 0.20 mmol/L) (rs = 0.803, p < 0.0001). The majority (96.81%) of values for serum BHB compared with POC BHB fell within 0.1 ± 0.1 mmol/L. The average of difference between serum and POC BHB (the bias) was 0.064 mmol/L (95% CI 0.047–0.081), and percentage error was 3.19%. Point‐of‐care BHB is accurate and comparable to serum BHB levels in our cohort of children after an overnight fast. Synopsis Point‐of‐care BHB agrees with serum values in healthy children.

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Approach to the Patient: Investigation of Pediatric Hypoglycemia in the Emergency Department—A Practical Algorithm

Thornton,

Hawkes

2024

The Journal of Clinical Endocrinology &Amp; Metabolism

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Hypoglycemia in the pediatric population tends to present in the newborn period or during metabolic crisis triggered by prolonged fasting and intercurrent illness. Current recommendations to investigate all children presenting with hypoglycemia for the first time are cumbersome and costly, but necessary to identify those with serious conditions that predispose to hypoglycemia. We describe a practical and cost-effective method of evaluating children who present to the emergency department with previously undiagnosed hypoglycemia. Glucose and point-of-care (POC) beta-hydroxybutyrate (G-BOHB) levels should be measured on all children with a low screening POC glucose levels, and a full history and physical examination will identify those requiring further investigation. This approach is suggested to identify patients with serious and life-threatening disease with the same fidelity as the currently recommended approach of performing a critical sample on all children with hypoglycemia. Our streamlined approach will reduce the cost to approximately 10% of the current approach per patient diagnosed with a serious underlying disease. Further, children without underlying hypoglycemia-predisposing disorders will be identified and discharged without unnecessary intervention.

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Method comparison of beta‐hydroxybutyrate point‐of‐care testing to serum in healthy children

Cited by 4 publications

References 15 publications

Dynamic Methods for Childhood Hypoglycemia Phenotyping: A Narrative Review

Dynamic Methods for Childhood Hypoglycemia Phenotyping: A Narrative Review

Method comparison of beta‐hydroxybutyrate point‐of‐care testing to serum in healthy children

Approach to the Patient: Investigation of Pediatric Hypoglycemia in the Emergency Department—A Practical Algorithm

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