Which substance is a ketone body used in ruling out diabetic ketoacidosis?

Which substance is a ketone body used in ruling out diabetic ketoacidosis?

• A. Acetoacetate
• B. Beta-hydroxybutyrate
• C. Acetone
• D. Pyruvate

Answer: (B)

When assessing suspected diabetic ketoacidosis, the ketone body that proves most informative to measure is beta-hydroxybutyrate. In DKA, the liver shifts toward producing beta-hydroxybutyrate as the dominant ketone because of the high NADH/NAD+ state. However, many routine bedside tests for ketosis detect acetoacetate (and acetone) rather than beta-hydroxybutyrate, so ketosis can be missed if this is the only measurement used. Therefore, directly measuring beta-hydroxybutyrate provides the most reliable indication of ketosis and helps rule out DKA when clinical concern remains but the conventional test is negative. Acetoacetate and acetone are other ketone bodies, but the common test detects primarily acetoacetate and may not reflect beta-hydroxybutyrate levels; pyruvate is not a ketone body at all.

When assessing suspected diabetic ketoacidosis, the ketone body that proves most informative to measure is beta-hydroxybutyrate. In DKA, the liver shifts toward producing beta-hydroxybutyrate as the dominant ketone because of the high NADH/NAD+ state. However, many routine bedside tests for ketosis detect acetoacetate (and acetone) rather than beta-hydroxybutyrate, so ketosis can be missed if this is the only measurement used. Therefore, directly measuring beta-hydroxybutyrate provides the most reliable indication of ketosis and helps rule out DKA when clinical concern remains but the conventional test is negative. Acetoacetate and acetone are other ketone bodies, but the common test detects primarily acetoacetate and may not reflect beta-hydroxybutyrate levels; pyruvate is not a ketone body at all.