Comment on Hamblin et al. Capillary Ketone Concentrations at the Time of Colonoscopy: A Cross-Sectional Study With Implications for SGLT2 Inhibitor –Treated Type 2 Diabetes. Diabetes Care 2021;44:e124–e126

The study on sodium –glucose cotransporter 2 inhibitor (SGLT2i) therapy by Hamblin et al. (1) advocates for increasing β-hydroxybutyrate (BHB) to 1.7 mmol/L for hyperketonemia, in contrast to our previously suggested threshold of 1.0 mmol/L (2). This change is premature, since the new cutoff is based on a nonnormally distributed data set, the risk of developing ketoacidosis is different in patients with diabetes compared with patients without diabetes, and a higher BHB threshold may increase the false-negative rate of early ketoacidosis.
Source: Diabetes Care - Category: Endocrinology Source Type: research