Ketone Management in Pediatric Diabetes Centers in the USA: Current Practices and a Call for Improved Standardization
Authors' conclusion
The preventable nature and high incidence of DKA highlight the need to build consensus for clinical ketone management and to develop tools to facilitate management, especially as the use of diabetes technologies continues to increase.
Study context
- Population
- Diabetes healthcare professionals (HCPs) managing youth with T1D in the USA (51% physicians, 26% diabetes educators, 19% nurse practitioners) from 47 institutions; 70% at academic specialty centers
- Participants
- 123 participants47 institutions
- Outcome
- Ketone management practices
Methodological detailsonline survey, 35-item
- Online survey
- 35-item
Main finding
As reported in the abstract
- Reported having ketone management protocols
- 79%
- Hyperglycemia level at which ketone monitoring advised
- >200 to 350 mg/dL
- Hyperglycemia duration at which ketone monitoring advised
- 0 min to >6 h
- Distinct ketone management protocols for pump users
- 72%
- Specific protocols for automated insulin delivery (AID)
- 29%
- Agreed diabetic ketoacidosis (DKA) due to infusion site failure was a significant problem
- 62%
- Agreed need to standardize ketone management guidelines
- 70%
Observational data: associations, not effects.
Further findings
Clinic technology use
- Reported >50% CGM use in clinic
- 97%
- Reported >50% insulin pump use
- 72%
Original publication
Ketone Management in Pediatric Diabetes Centers in the USA: Current Practices and a Call for Improved Standardization. Horm Res Paediatr. Published 15 October 2024. doi:10.
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