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Original Research
Retrospective Audit of Serum Ketone Tests Performed at National Health Laboratory Service Tygerberg Hospital
The Journal of Medical Laboratory Science & Technology of South Africa | Vol 1, No 4 | a108 |
DOI: https://doi.org/10.4102/jmlstsa.v1i4.108
| © 2019 The Society of Medical Laboratory Technologists of South Africa (SMLTSA)
| This work is licensed under Other
Submitted: 15 January 2026 | Published: 15 November 2019
Submitted: 15 January 2026 | Published: 15 November 2019
About the author(s)
M.C. Bezuidenhout, Stellenbosch University, South AfricaR.T. Erasmus, Stellenbosch University, South Africa
A.E. Zemlin, Stellenbosch University, South Africa; and, National Health Laboratory Service, South Africa
Full Text:
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Introduction: Diabetes mellitus (DM) is characterised by hyperglycaemia as a result of impaired insulin secretion or resistance. A severe complication Type 1 and Type 2 DM is the development of diabetic ketoacidosis (DKA) due to ketone production. Monitoring serum ketone levels aids the diagnosis and management of DKA.
Methods: A retrospective audit was performed to determine the number of serum ketone tests performed at Tygerberg Hospital National Health Laboratory Service (NHLS) over a 6-month period to evaluate the need to introduce ? –hydroxybutyrate (?-OHB) testing, possibly as point-of-care test (POCT).
Results: During this period, 255 serum ketone tests were performed - 189 were used in this study. Of these, 56% (n=105) were requested for patients with Type 1 and Type 2 diabetes with suspected DKA, of which only 59% (n=62) tested positive. The average turnaround time (TAT) was 5.5 hours with 89% (n=169) exceeding the proposed stability period of 2 hours.
Conclusion: The large proportion of negative results could be due to the instability of ketones at ambient temperature, the significant delay in TAT and the fact that acetoacetate and not ?-OHB is measured. A ?-OHB POCT device would bridge this gap, but this would first necessitate full method validation.
Methods: A retrospective audit was performed to determine the number of serum ketone tests performed at Tygerberg Hospital National Health Laboratory Service (NHLS) over a 6-month period to evaluate the need to introduce ? –hydroxybutyrate (?-OHB) testing, possibly as point-of-care test (POCT).
Results: During this period, 255 serum ketone tests were performed - 189 were used in this study. Of these, 56% (n=105) were requested for patients with Type 1 and Type 2 diabetes with suspected DKA, of which only 59% (n=62) tested positive. The average turnaround time (TAT) was 5.5 hours with 89% (n=169) exceeding the proposed stability period of 2 hours.
Conclusion: The large proportion of negative results could be due to the instability of ketones at ambient temperature, the significant delay in TAT and the fact that acetoacetate and not ?-OHB is measured. A ?-OHB POCT device would bridge this gap, but this would first necessitate full method validation.
Keywords
diabetes; ketones; diabetic ketoacidosis; point of care testing
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