Ketone 101: Monitoring, Management and DKA Risk Across Populations | Recording-Ketone 101: Monitoring, Management and DKA Risk Across Populations

Video Transcription

Video Summary

This webinar from the American Diabetes Association reviewed “Ketone 101,” focusing on ketone monitoring, DKA prevention, and management across populations. Dr. Eden Miller explained that ketones are produced when the body burns fat due to relative insulin deficiency, which can occur with missed insulin, illness, pump failure, pregnancy, steroid use, ketogenic diets, or SGLT2 inhibitor therapy. She emphasized that ketones may rise before glucose becomes very high, so ketone monitoring should not be limited to patients with severe hyperglycemia. A key message was that every person with diabetes should have a ketone discussion and, for many, a clear ketone action plan.<br /><br />Dr. David Klonoff reviewed the 2024 ADA/EASD hyperglycemic crisis consensus report. He highlighted updated diagnostic criteria for DKA: diabetes, ketosis, and acidosis, with beta-hydroxybutyrate preferred for diagnosis and monitoring. He also outlined the distinction between DKA and HHS, noted that DKA can present with glucose below 200 mg/dL in some cases, and explained that mild to moderate DKA may sometimes be managed with subcutaneous rapid-acting insulin in monitored settings. Prevention and post-discharge follow-up were stressed.<br /><br />Dr. Celeste Dernwald discussed the special risks of DKA in pregnancy, where it can occur at lower glucose levels and carries significant fetal and maternal risk. She reviewed pregnancy physiology, common triggers, and a case showing successful treatment with IV fluids, insulin, and close fetal monitoring.<br /><br />The webinar closed with a type 2 diabetes case involving steroid-induced, SGLT2-associated euglycemic DKA, reinforcing the need for individualized ketone plans and future continuous ketone monitoring technology.

Keywords

ketone monitoring

diabetic ketoacidosis

DKA prevention

beta-hydroxybutyrate

hyperglycemic crisis

pregnancy DKA

SGLT2 inhibitor

euglycemic DKA

insulin deficiency

ketone action plan