Specimen requirement

Adult patient:

Heparin gel tube

Minimum blood volume: 5 mL

Paediatric patient:

Paediatric heparin tube

Number of vials: 1

Minimum blood volume: 1.3 mL

Authorisation code required

No

24 Hr available service

Yes 

Precaution

Send the blood sample in ice-water bath to the laboratory immediately for analysis.

Method

Spectrophotometry

Reference interval

Fasting plasma β-OHB < 0.3 mmol/L

(Source: from manufacturer’s kit insert)

Clinical indication

Investigation of patients presenting with hypoglycemia, metabolic acidosis with an increased anion gap, or suspected alcohol ingestion.   

Result interpretation

Increase in plasma β-OHB level indicates the presence of ketosis, e.g. fasting, diabetes mellitus, alcoholism or drug-related.

Use of sodium-glucose cotransporter 2 (SGLT2) inhibitors may be at risk of euglycemic diabetic ketoacidosis.

In paediatric patients, a hypo- or hyper-ketotic state (with or without hypoglycaemia) may suggest specific groups of metabolic disorders.

Measurement of uncertainty

See table.

Frequency of measurement

Urgent