Capillary Ketone Concentrations at the Time of Colonoscopy: A Cross-Sectional Study With Implications for SGLT2 Inhibitor-Treated Type 2 Diabetes

Peter S Hamblin^{1

2}, Rosemary Wong^{3

4}, Elif I Ekinci^{5

6}, Shoshana Sztal-Mazer^{7

8

9}, Shananthan Balachandran³, Aviva Frydman¹⁰, Timothy P Hanrahan¹¹, Raymond Hu^{6

12}, Shara N Ket¹³, Alan Moss^{2

14}, Mark Ng^{4

15}, Sashikala Ragunathan^{16

17}, Leon A Bach^{7

18}

Affiliations

¹ Department of Endocrinology and Diabetes, Western Health, Melbourne, Australia peter.hamblin@wh.org.au.
² Department of Medicine, Western Health, The University of Melbourne, Melbourne, Australia.
³ Department of Endocrinology and Diabetes, Eastern Health, Melbourne, Australia.
⁴ Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
⁵ Department of Endocrinology, Austin Health, Melbourne, Australia.
⁶ Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
⁷ Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Australia.
⁸ School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
⁹ Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
¹⁰ Department of Endocrinology and Diabetes, Western Health, Melbourne, Australia.
¹¹ Department of Gastroenterology and Liver Transplant Unit, Austin Health, Melbourne, Australia.
¹² Department of Anaesthesia, Austin Health, Melbourne, Australia.
¹³ Department of Gastroenterology, Alfred Health, Melbourne, Australia.
¹⁴ Department of Endoscopic Services, Western Health, Melbourne, Australia.
¹⁵ Department of Anaesthesia, Pain and Perioperative Medicine, Eastern Health, Melbourne, Australia.
¹⁶ Department of Gastroenterology, Austin Health, Melbourne, Australia.
¹⁷ Gastroenterological Nurses College of Australia, Melbourne, Australia.
¹⁸ Department of Medicine (Alfred), Monash University, Victoria, Australia.

PMID: 33896795
PMCID: PMC8247528
DOI: 10.2337/dc21-0256

Capillary Ketone Concentrations at the Time of Colonoscopy: A Cross-Sectional Study With Implications for SGLT2 Inhibitor-Treated Type 2 Diabetes

Peter S Hamblin et al. Diabetes Care. 2021 Jun.

. 2021 Jun;44(6):e124-e126.

doi: 10.2337/dc21-0256. Epub 2021 Apr 25.

Authors

Affiliations

¹ Department of Endocrinology and Diabetes, Western Health, Melbourne, Australia peter.hamblin@wh.org.au.
² Department of Medicine, Western Health, The University of Melbourne, Melbourne, Australia.
³ Department of Endocrinology and Diabetes, Eastern Health, Melbourne, Australia.
⁴ Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
⁵ Department of Endocrinology, Austin Health, Melbourne, Australia.
⁶ Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
⁷ Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Australia.
⁸ School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
⁹ Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
¹⁰ Department of Endocrinology and Diabetes, Western Health, Melbourne, Australia.
¹¹ Department of Gastroenterology and Liver Transplant Unit, Austin Health, Melbourne, Australia.
¹² Department of Anaesthesia, Austin Health, Melbourne, Australia.
¹³ Department of Gastroenterology, Alfred Health, Melbourne, Australia.
¹⁴ Department of Endoscopic Services, Western Health, Melbourne, Australia.
¹⁵ Department of Anaesthesia, Pain and Perioperative Medicine, Eastern Health, Melbourne, Australia.
¹⁶ Department of Gastroenterology, Austin Health, Melbourne, Australia.
¹⁷ Gastroenterological Nurses College of Australia, Melbourne, Australia.
¹⁸ Department of Medicine (Alfred), Monash University, Victoria, Australia.

PMID: 33896795
PMCID: PMC8247528
DOI: 10.2337/dc21-0256

No abstract available

PubMed Disclaimer

Figures

**Figure 1**
Capillary ketone concentrations at the time of colonoscopy in people with normoglycemia and with diabetes. The dashed line represents capillary ketone concentration 0.6 mmol/L, the generally quoted overnight fasting upper limit of normal. Normoglycemia, reference population of community-dwelling adults with capillary fasting glucose <5.5 mmol/L and no history of diabetes (n = 151); non-SGLT2i-treated diabetes, people with type 2 diabetes either not usually treated with SGLT2i or not receiving SGLT2i within 80 h of colonoscopy (n = 105); SGLT2i-treated diabetes, people with type 2 diabetes who have received SGLT2i within 80 h of colonoscopy (n = 37). Ketones refers to the measurement of β-hydroxybutyrate. P = 0.051 overall between the three groups, Kruskal-Wallis test.

See this image and copyright information in PMC

Comment in

Response to 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.
Hamblin PS, Wong R, Ekinci EI, Sztal-Mazer S, Balachandran S, Frydman A, Hanrahan TP, Hu R, Ket SN, Moss A, Ng M, Ragunathan S, Bach LA. Hamblin PS, et al. Diabetes Care. 2022 Jan 1;45(1):e17-e18. doi: 10.2337/dci21-0048. Diabetes Care. 2022. PMID: 34986256 No abstract available.
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.
Thiruvenkatarajan V, Meyer EJ, Jesudason D. Thiruvenkatarajan V, et al. Diabetes Care. 2022 Jan 1;45(1):e15-e16. doi: 10.2337/dc21-1413. Diabetes Care. 2022. PMID: 34986260 No abstract available.

References

1. Meyer EJ, Mignone E, Hade A, Thiruvenkatarajan V, Bryant RV, Jesudason D. Periprocedural euglycemic diabetic ketoacidosis associated with sodium-glucose cotransporter 2 inhibitor therapy during colonoscopy. Diabetes Care 2020;43:e181–e184 - PMC - PubMed
1. Australian Diabetes Society . Alert update September 2020. Periprocedural diabetic ketoacidosis (DKA) with SGLT2 inhibitor use. Accessed 16 January 2021. Available from https://diabetessociety.com.au/downloads/20201015%20ADS_DKA_SGLT2i_Alert...
1. Solberg HE, PetitClerc C. International Federation of Clinical Chemistry (IFCC), Scientific Committee, Clinical Section, Expert Panel on Theory of Reference Values. Approved recommendation (1988) on the theory of reference values. Part 3. Preparation of individuals and collection of specimens for the production of reference values. J Clin Chem Clin Biochem 1988;26:593–598 - PubMed
1. Ceriotti F, Kaczmarek E, Guerra E, et al. . Comparative performance assessment of point-of-care testing devices for measuring glucose and ketones at the patient bedside. J Diabetes Sci Technol 2015;9:268–277 - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions
Actions

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Capillary Ketone Concentrations at the Time of Colonoscopy: A Cross-Sectional Study With Implications for SGLT2 Inhibitor-Treated Type 2 Diabetes

Affiliations

Capillary Ketone Concentrations at the Time of Colonoscopy: A Cross-Sectional Study With Implications for SGLT2 Inhibitor-Treated Type 2 Diabetes

Authors

Affiliations

Figures

Comment in

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources