Multicentric evaluation of eight glucose and four ketone blood meters

Guimont, Marc-Antoine; Desjobert, H.; Fonfrède, Michele; Vitoux, Dominique; Benoist, Jean‐François; Launay, Jean‐Marie; Peoc’h, Katell; Lefèvre, Guillaume

doi:10.1016/j.clinbiochem.2015.07.032

Cited by 12 publications

(10 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Normally they are used for capillary blood by finger pricks (BHBc), but they may also be used for venous whole blood (BHBv). Several validation studies have compared different POC meters with standard laboratory analyses on plasma (BHBp) (5,12,15,27), and capillary POC testing has also been compared with liquid chromatography-tandem mass spectrometry on the same finger pricks (16). In general, the authors of these aforementioned studies conclude satisfactory performance of the POC meters, albeit with a tendency to underestimate concentrations over 3-4 mmol/L.…”

Section: Introductionmentioning

confidence: 99%

Capillary blood tests may overestimate ketosis: triangulation between three different measures of β-hydroxybutyrate

Norgren

Sindi

Sandebring‐Matton

et al. 2020

American Journal of Physiology-Endocrinology and Metabolism

View full text Add to dashboard Cite

The ketone body β-hydroxybutyrate (BHB), assessed by a point-of-care meter in venous whole blood (BHBv), was used as the main outcome in a study on nutritional ketosis in healthy older adults. Two other BHB measures were also used in the study for validation and exploratory purposes, and here we report findings on correlation and agreement between those three methods. Ketosis in the range of 0–1.5 mmol/L was induced in 15 healthy volunteers by intake of medium-chain fatty acids after a 12-h fast. BHBv was assessed at 12 time points for 4 h. The same point-of-care meter was also used to test capillary blood (BHBc) at three time points, and a laboratory test determined total ketones (TK) in plasma (BHBp + acetoacetate) at four time points. A total of 180 cases included simultaneous data on BHBv, BHBc, BHBp, and TK. TK correlated with BHBp (Pearson’s r = 0.99), BHBv ( r = 0.91), and BHBc ( r = 0.91), all P < 0.0001. BHBv and BHBp had good agreement in absolute values. However, the slope between BHBc and BHBv, measured with the same device, was in the range of 0.64–0.78 in different regression models, indicating substantially higher BHB concentrations in capillary versus venous blood. We conclude that all three methods are valid to detect relative changes in ketosis, but our results highlight the importance of method considerations and the possible need to adjust cutoffs, e.g., in the management of ketoacidosis and in the evaluation and comparison of dietary interventions.

show abstract

Section: Introductionmentioning

confidence: 99%

Capillary blood tests may overestimate ketosis: triangulation between three different measures of β-hydroxybutyrate

Norgren

Sindi

Sandebring‐Matton

et al. 2020

American Journal of Physiology-Endocrinology and Metabolism

View full text Add to dashboard Cite

show abstract

“…These results suggest that neither breath acetone nor urinary ketone measurements accurately reflect the rapid changes in blood ketone concentrations after ketone drinks, and that blood measurement should be the preferred method to quantitatively describe ketosis. That said, it should be noted that although commercial handheld monitors are the most practical and widely available tool for measuring blood ketones, they can overestimate blood D-βHB compared to laboratory measures (Guimont et al, 2015 ) and these monitors do not measure L-βHB and so may not provide accurate total blood ketone concentrations, especially if a racemic ketone salt has been consumed.…”

Section: Discussionmentioning

confidence: 99%

On the Metabolism of Exogenous Ketones in Humans

et al. 2017

View full text Add to dashboard Cite

Background and aims: Currently there is considerable interest in ketone metabolism owing to recently reported benefits of ketosis for human health. Traditionally, ketosis has been achieved by following a high-fat, low-carbohydrate “ketogenic” diet, but adherence to such diets can be difficult. An alternative way to increase blood D-β-hydroxybutyrate (D-βHB) concentrations is ketone drinks, but the metabolic effects of exogenous ketones are relatively unknown. Here, healthy human volunteers took part in three randomized metabolic studies of drinks containing a ketone ester (KE); (R)-3-hydroxybutyl (R)-3-hydroxybutyrate, or ketone salts (KS); sodium plus potassium βHB.Methods and Results: In the first study, 15 participants consumed KE or KS drinks that delivered ~12 or ~24 g of βHB. Both drinks elevated blood D-βHB concentrations (D-βHB Cmax: KE 2.8 mM, KS 1.0 mM, P < 0.001), which returned to baseline within 3–4 h. KS drinks were found to contain 50% of the L-βHB isoform, which remained elevated in blood for over 8 h, but was not detectable after 24 h. Urinary excretion of both D-βHB and L-βHB was <1.5% of the total βHB ingested and was in proportion to the blood AUC. D-βHB, but not L-βHB, was slowly converted to breath acetone. The KE drink decreased blood pH by 0.10 and the KS drink increased urinary pH from 5.7 to 8.5. In the second study, the effect of a meal before a KE drink on blood D-βHB concentrations was determined in 16 participants. Food lowered blood D-βHB Cmax by 33% (Fed 2.2 mM, Fasted 3.3 mM, P < 0.001), but did not alter acetoacetate or breath acetone concentrations. All ketone drinks lowered blood glucose, free fatty acid and triglyceride concentrations, and had similar effects on blood electrolytes, which remained normal. In the final study, participants were given KE over 9 h as three drinks (n = 12) or a continuous nasogastric infusion (n = 4) to maintain blood D-βHB concentrations greater than 1 mM. Both drinks and infusions gave identical D-βHB AUC of 1.3–1.4 moles.min.Conclusion: We conclude that exogenous ketone drinks are a practical, efficacious way to achieve ketosis.

show abstract

“…Considering the potential for hyperketonemia to downregulate glycolysis and suppress adipocyte lipolysis, the optimal range of KB concentration to enhance substrate provision and energy production remains obscure. This is exacerbated by differences in the bioavailability of various ketone supplements and measurement discrepancy of point-of-care versus laboratory-based methods (Guimont et al, 2015;Leckey et al, 2017), thus making comparisons between studies difficult. For example, following the ingestion of the D-βHB R-1,3-butanediol monoester within a carbohydrate drink, plasma D-βHB was maintained above ∼2.0-3.0 mmol/L and improved performance during a preloaded 30-min cycling TT by ∼2% compared with the ingestion of an isoenergetic carbohydrate-only drink (Cox et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

The Effect of 1,3-Butanediol on Cycling Time-Trial Performance

Shaw

Mérien

Braakhuis

et al. 2019

International Journal of Sport Nutrition and Exercise Metabolism

View full text Add to dashboard Cite

This study investigated the effect of the racemic β-hydroxybutyrate (βHB) precursor, R,S-1,3-butanediol (BD), on time-trial (TT) performance and tolerability. A repeated-measures, randomized, crossover study was conducted in nine trained male cyclists (age, 26.7 ± 5.2 years; body mass, 69.6 ± 8.4 kg; height, 1.82 ± 0.09 m; body mass index, 21.2 ± 1.5 kg/m2; VO2peak,63.9 ± 2.5 ml·kg−1·min−1; Wmax, 389.3 ± 50.4 W). Participants ingested 0.35 g/kg of BD or placebo 30 min before and 60 min during 85 min of steady-state exercise, which preceded a ∼25- to 35-min TT (i.e., 7 kJ/kg). The ingestion of BD increased blood D-βHB concentration throughout exercise (0.44–0.79 mmol/L) compared with placebo (0.11–0.16 mmol/L; all p < .001), which peaked 1 hr following the TT (1.38 ± 0.35 vs. 0.34 ± 0.24 mmol/L; p < .001). Serum glucose and blood lactate concentrations were not different between trials (all p > .05). BD ingestion increased oxygen consumption and carbon dioxide production after 20 min of steady-state exercise (p = .002 and p = .032, respectively); however, no further effects on cardiorespiratory parameters were observed. Within the BD trial, moderate to severe gastrointestinal symptoms were reported in five participants, and low levels of dizziness, nausea, and euphoria were reported in two participants. However, this had no effect on TT duration (placebo, 28.5 ± 3.6 min; BD, 28.7 ± 3.2 min; p = .62) and average power output (placebo, 290.1 ± 53.7 W; BD, 286.4 ± 45.9 W; p = .50). These results suggest that BD has no benefit for endurance performance.

show abstract

Multicentric evaluation of eight glucose and four ketone blood meters

Cited by 12 publications

References 21 publications

Capillary blood tests may overestimate ketosis: triangulation between three different measures of β-hydroxybutyrate

Capillary blood tests may overestimate ketosis: triangulation between three different measures of β-hydroxybutyrate

On the Metabolism of Exogenous Ketones in Humans

The Effect of 1,3-Butanediol on Cycling Time-Trial Performance

Contact Info

Product

Resources

About