Breath Acetone Correlates With Capillary β-hydroxybutyrate in Type 1 Diabetes
Authors' conclusion
In adults with type 1 diabetes, measurement of breath acetone provides a noninvasive estimate of blood BOHB concentration. The correlation between BrACE and BOHB was suboptimal during unsupervised outpatient care, but was strong during supervised insulin withdrawal.
Study context
- Population
- People with T1D20 completed
- Comparison
- Breath acetone (BrACE) vs capillary blood β-hydroxybutyrate (BOHB), with and without dapagliflozin
- Primary endpoint
- Correlation between BrACE and BOHB (Spearman's ρ)
Methodological detailsrandomized crossover, supervised insulin withdrawal, Paired BOHB and BrACE measured 3 times daily during outpatient periods, hourly during supervised insulin withdrawal
- Randomized crossover
- Supervised insulin withdrawal
- Paired BOHB and BrACE measured 3 times daily during outpatient periods, hourly during supervised insulin withdrawal
Primary result
As reported in the abstract
Outpatient periods: moderate correlation (n = 1425 paired readings), Spearman's ρ, 95% CI 0.36 to 0.45, P < .0001
.41
Insulin withdrawal: strong correlation (n = 246 paired values), Spearman's ρ, 95% CI 0.77 to 0.85
.81
Further findings
ROC analysis: BrACE > 5 ppm for detecting capillary BOHB ≥ 1.5 mmol/L
- Sensitivity
- 93%
- Specificity
- 87%
- Optimal threshold
Safety
- No serious adverse events occurred
Original publication
Breath Acetone Correlates With Capillary β-hydroxybutyrate in Type 1 Diabetes. J Diabetes Sci Technol. Published 22 April 2025. doi:10.
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