Premium
Urine versus blood ketones
Author(s) -
Brewster Sarah,
Curtis Louise,
Poole Ruth
Publication year - 2017
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.2070
Subject(s) - medicine , diabetic ketoacidosis , diabetes mellitus , urinalysis , insulin , ketonuria , ketoacidosis , urinary system , pediatrics , type 1 diabetes , intensive care medicine , endocrinology
What are ketones? Ketones are produced when fatty acids are metabolised in the liver in the absence of glucose as an energy source. This process is known as ketogenesis, and results in the formation of three different types of ketone bodies: 3-beta-hydroxybutyrate (3-β-OHB) comprising 78% of the circulating ketone bodies, acetoacetate 20%, and acetone the remaining 2%.1 As demonstrated in Figure 1, during ketogenesis acetoacetate is the main product. This is reduced in the mitochondria to form 3-βOHB, and also undergoes spontaneous decarboxylation to form acetone, a substance which can be detected on the breath as a sweet odour. The principal ketone bodies, 3-βOHB and acetoacetate, are transported from the liver to tissues where they are used as a source of energy. The brain is an organ that relies on ketones in states of relative carbohydrate deficiency, as it is unable to break down fatty acids itself.1