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Blood ketones

Sebastian Hörber, Sarah Hudak, Martin Kächele, Dietrich Overkamp, Andreas Fritsche, Hans-Ulrich Häring, Andreas Peter, Martin Heni
Diabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency unit with severely altered mental status but stable vital signs. Laboratory results on admission revealed very high blood glucose (1687 mg/dL/93.6 mmol/L) and severe acidosis (pH <7) with proof of ketone bodies in serum and urine...
September 25, 2018: Endocrinology, Diabetes & Metabolism Case Reports
Riley L Svec, Lucia Furiassi, Christine G Skibinski, Timothy M Fan, Gregory J Riggins, Paul J Hergenrother
Even in the era of personalized medicine and immunotherapy, temozolomide (TMZ), a small molecule DNA alkylating agent, remains the standard-of-care for glioblastoma (GBM). TMZ has an unusual mode-of-action, spontaneously converting to its active component via hydrolysis in vivo. While TMZ has been FDA approved for two decades, it provides little benefit to patients whose tumors express the resistance enzyme MGMT and gives rise to systemic toxicity through myelosuppression. TMZ was first synthesized in 1984, but certain key derivatives have been inaccessible due to the chemical sensitivity of TMZ, precluding broad exploration of the link between imidazotetrazine structure and biological activity...
October 8, 2018: ACS Chemical Biology
Julio Rosenstock, Jan Marquard, Lori M Laffel, Dietmar Neubacher, Stefan Kaspers, David Z Cherney, Bernard Zinman, Jay S Skyler, Jyothis George, Nima Soleymanlou, Bruce A Perkins
OBJECTIVE: To evaluate the safety and efficacy of empagliflozin 10- and 25-mg doses plus a unique lower dose (2.5 mg) as adjunct to intensified insulin in patients with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: The EASE (Empagliflozin as Adjunctive to inSulin thErapy) program ( N = 1,707) included two double-blind, placebo-controlled phase 3 trials: EASE-2 with empagliflozin 10 mg ( n = 243), 25 mg ( n = 244), and placebo ( n = 243), 52-week treatment; and EASE-3 with empagliflozin 2...
October 4, 2018: Diabetes Care
Ceren Yarar-Fisher, Adarsh Kulkarni, Jia Li, Paige Farley, Cassandra Renfro, Hammad Aslam, Patrick Bosarge, Landon Wilson, Stephen Barnes
Study design: Longitudinal, randomized study. Objectives: (1) Test the safety and feasibility of a ketogenic diet (KD) intervention in the acute stages of spinal cord injury (SCI), (2) assess the effects of a KD on neurological recovery, and (3) identify potential serum biomarkers associated with KD-induced changes in neurological recovery. Setting: Acute care and rehabilitation facility. Methods: The KD is a high-fat, low-carbohydrate diet that includes ≈70-80% total energy as fat...
2018: Spinal Cord Series and Cases
F Bonnet, A J Scheen
Chronic low-grade inflammation is a recognized key feature associated with type 2 diabetes mellitus (T2DM) and its complications. In prospective randomized trials, sodium-glucose cotransporter type 2 (SGLT2) inhibitors have demonstrated benefits related to several cardiovascular and renal risk factors, including HbA1c , blood pressure, body weight, renal hyperfiltration and improvement of cardiorenal outcomes. SGLT2 inhibitors may improve adipose tissue function and induce decreases in serum leptin, TNF-α and IL-6 while increasing adiponectin...
September 26, 2018: Diabetes & Metabolism
Masako Fujiwara, Itiro Ando, Keisuke Satoh, You Shishido, Kazuhito Totsune, Hiroshi Sato, Yutaka Imai
Recently, the ratio of patients with diabetes mellitus (DM) among hemodialysis (HD) patients has increased to become the largest sub-population. Their prognoses are significantly worse than those of patients without diabetes (non-DM). In the present study, 10 DM patients who did not take meals and 10 non-DM patients who took meals during HD sessions were investigated. The time courses of the change in plasma levels of metabolites during HD were determined. DM patients exhibited decreased plasma levels of lactate, pyruvate and alanine and dramatically increased levels of ketone bodies...
2018: PloS One
Rocío Escartín, Nuria Brun, M Nieves García Monforte, Joan Carles Ferreres, Raquel Corripio
BACKGROUND Insulinomas are pancreatic neuroendocrine tumors that cause non-ketotic hypoglycemia due to hyperinsulinism; they are extremely rare, especially in children. CASE REPORT We present a case of a sporadic insulinoma in an 11-year-old boy who had episodes of self-limited drowsiness and behavior changes over a 3-month period, thought to be caused by psychological issues. Non-ketotic hypoglycemia was confirmed at our center. A fasting blood test found inappropriately elevated insulin levels during hypoglycemia, undetectable β-hydroxybutyrate, and increased C-peptide levels in line with insulin levels...
September 21, 2018: American Journal of Case Reports
Desiree Abdurrachim, Xing Qi Teo, Chern Chiuh Woo, Wei Xin Chan, Janise Lalic, Carolyn S P Lam, Philip Teck Hock Lee
AIMS: Sodium glucose cotransporter-2 inhibitors (SGLT2i) have been shown to reduce the risk of cardiovascular events in clinical trials; yet the underlying mechanisms for cardio-protection remain poorly understood. Increased myocardial ketone body utilization has been hypothesized to contribute to improved cardiac metabolic efficiency with SGLT2i, but this has not been conclusively demonstrated. We investigated the effects of the SGLT2i empagliflozin on myocardial ketone body utilization in diabetic, obese spontaneously hypertensive heart failure (SHHF) rats, after six months of treatment...
September 17, 2018: Diabetes, Obesity & Metabolism
Rachel Kadakia, Denise M Scholtens, Gerald W Rouleau, Octavious Talbot, Olga R Ilkayeva, Tabitha George, Jami L Josefson
OBJECTIVE: To evaluate the association between cord blood amino acid and acylcarnitine profiles and measures of adiposity and hyperinsulinemia in healthy newborns. STUDY DESIGN: A cross-sectional study of 118 full-term infants born to mothers without gestational diabetes was performed. Cord blood leptin, C-peptide, acylcarnitine, and amino acid levels were measured. Body composition was measured by air displacement plethysmography. Multivariate linear regression and principal component analysis were used to analyze associations of cord blood metabolites with newborn anthropometrics, leptin, and C-peptide...
September 10, 2018: Journal of Pediatrics
Alexis P Roodt, Yvette Naudé, Anton Stoltz, Egmont Rohwer
Volatile organic compounds (VOCs) emanating from the surfaces of human skin are of great interest to researchers in medical and forensic fields, as well as to biologists studying the ecology of blood-feeding insect vectors of human disease. Research involving the comparison of relative abundances of VOCs emanating from human skin is currently limited by the methodology used for sample collection and pre-concentration. The use of in-house developed silicone rubber (polydimethylsiloxane (PDMS)) passive sampling devices constructed in the form of bracelets and anklets was explored to address this need...
September 3, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Daniel Edson, Hume Field, Lee McMichael, David Mayer, John Martin, Justin Welbergen, Amanda McLaughlin, Lauren Huth, Joanna Kristoffersen, George Tsoukalas, Peter Kirkland
The grey-headed flying fox ( Pteropus poliocephalus) is a species endemic to coastal eastern Australia. This study presents a comprehensive set of biochemistry, hematology, and urinalysis biomarkers from which reference values were derived. Blood samples collected from free-ranging P. poliocephalus were submitted for hematology ( n = 140) and plasma biochemistry ( n = 161) and urine for urinalysis ( n = 95). The values for P. poliocephalus were broadly consistent with those values published for other Australian Pteropus species...
September 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
R J Burstal, J R Reilly, B Burstal
Prolonged fasting leads to a shift from carbohydrate to fat as the primary energy source, resulting in the production of ketones such as beta-hydroxybutyrate. Hyperketonaemia and ketoacidosis have been observed in young children fasting for surgery. The aim of this study was to investigate ketonaemia in adults fasted for surgery. One hundred non-diabetic adults presenting for elective or emergency surgery were assessed for the presence of hyperketonaemia (beta-hydroxybutyrate levels more than 1 mmol/l), and the relationship between beta-hydroxybutyrate, blood glucose and fasting duration was investigated...
September 2018: Anaesthesia and Intensive Care
Alexandra Clément, Henri Boutley, Sylvain Poussier, Julien Pierson, Mickael Lhuillier, Allan Kolodziej, Jean-Luc Olivier, Gilles Karcher, Pierre-Yves Marie, Fatiha Maskali
BACKGROUND: Short periods of fasting and/or low-carbohydrate diet have been proven beneficial for decreasing the myocardial uptake of 18 F-fluorodeoxyglucose (18 F-FDG) and enhancing the detection of inflammatory heart diseases by 18 F-FDG positron emission tomography (PET). This study aimed at determining whether this benefit is increased when a low-carbohydrate ketogenic diet is prolonged up to 7 days. METHODS: Wistar rats underwent serial 18 F-FDG-PET imaging after an 18-hour fasting period and after 2, 4 and 7 days of a ketogenic diet (3% carbohydrate) and they were compared to rats submitted to the same protocol but with normal diet (44% carbohydrate)...
August 20, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Martin Voss, Nadja I Lorenz, Anna-Luisa Luger, Joachim P Steinbach, Johannes Rieger, Michael W Ronellenfitsch
Cancer metabolism is characterized by extensive glucose consumption through aerobic glycolysis. No effective therapy exploiting this cancer trait has emerged so far, in part, due to the substantial side effects of the investigated drugs. In this study, we examined the side effects of a combination of isocaloric ketogenic diet (KD) with the glycolysis inhibitor 2-deoxyglucose (2-DG). Two groups of eight athymic nude mice were either fed a standard diet (SD) or a caloric unrestricted KD with a ratio of 4 g fat to 1 g protein/carbohydrate...
August 20, 2018: International Journal of Molecular Sciences
Da-Som Kim, Young-Min Goo, Jinju Cho, Jookyeong Lee, Dong Yeol Lee, Seung Mi Sin, Young Sook Kil, Won Min Jeong, Keon Hee Ko, Ki Jeung Yang, Yun Geun Kim, Sang Gon Kim, Kiseong Kim, Young Jun Kim, Jae Kyeom Kim, Eui-Cheol Shin
This study identified the volatile organic compounds in the essential oils that are extracted from Chrysanthemum indicum Linné ( C. indicum Linné) and investigated the effects of the inhalation of these compounds. We detected a total of 41 volatile organic compounds, including 32 hydrocarbons, four acids, three alcohols, two ketones, and one aldehyde. In a sniffing test, seven types of volatile organic compounds were identified. Furthermore, the volatile organic compounds in C. indicum Linné that were identified were found to be derived from 1,8-cineole and camphor...
August 17, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Zhong-Hui Guo, Zhi-Xin Jia, Kui-Kui Chen, Jie Liu, Wen-Juan Xu, Fei-Peng Duan, Zhong Xian, Zi-Yi Wei, Lian-Ming Chen, Hong-Bin Xiao
To explore the drug-induced constituents in vivo of Polygonum multiflorum extract (PM). This study was the first to study the drug-induced constituents in target organ liver. Agilent MassHunter qualitative analysis software and Metabolite ID software were applied for the analysis of retention time, exact relative molecular mass, primary and secondary mass spectrum information based on ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and targeted-MS/MS. By comparison with literature and standards, a total of 5 prototypes and 6 metabolites were identified or tentatively elucidated from the liver samples...
July 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Eugenio Cersosimo, John M Miles
BACKGROUND & INTRODUCTION: The advent of the sodium-glucose cotransporter-2 inhibitors [SGLT-2i] provides an additional tool to combat diabetes and complications. The use of SGLT-2i leads to effective and durable glycemic control with important reductions in body weight/fat and blood pressure. These agents may delay beta-cell deterioration and improve tissue insulin sensitivity, which might slow the progression of the disease. METHODS & RESULTS: In response to glycosuria, a compensatory rise in endogenous glucose production, sustained by a decrease in plasma insulin with an increase in glucagon has been described...
August 13, 2018: Current Diabetes Reviews
Lori M Laffel, Catarina Limbert, Helen Phelan, Anju Virmani, Jamie Wood, Sabine E Hofer
No abstract text is available yet for this article.
October 2018: Pediatric Diabetes
Rekha Narasimhan, Roxana Coras, Sara B Rosenthal, Shannon R Sweeney, Alessia Lodi, Stefano Tiziani, David Boyle, Arthur Kavanaugh, Monica Guma
BACKGROUND: Metabolomics is an emerging field of biomedical research that may offer a better understanding of the mechanisms of underlying conditions including inflammatory arthritis. Perturbations caused by inflamed synovial tissue can lead to correlated changes in concentrations of certain metabolites in the synovium and thereby function as potential biomarkers in blood. Here, we explore the hypothesis of whether characterization of patients' metabolomic profiles in blood, utilizing 1 H-nuclear magnetic resonance (NMR), predicts synovial marker profiling in rheumatoid arthritis (RA)...
August 3, 2018: Arthritis Research & Therapy
Jakob Heimer, Dominic Gascho, Barbara Fliss, Rosa Maria Martinez, Niklaus Zoelch
We report a fetal loss following maternal ketoacidosis in a case of cryptic pregnancy. Biochemical analysis of peripheral blood revealed highly elevated levels of beta-hydroxybutyrate (BHB) in the mother (9.2 mmol/l) and the fetus (4.2 mmol/l). Fetal ketoacidosis with hypoxic-ischemic brain damage was determined to be the cause of death. 1 H-MRS of the right cerebral hemisphere presented with distinctive resonances of BHB and acetone. Acetoacetate and glucose were not detected. Due to reported chronic abuse of ethanol and a period of fasting, alcoholic ketoacidosis was concluded to be the cause of the metabolic disorder...
October 2018: Journal of Forensic and Legal Medicine
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