MLT GlobeBeta-hydroxybutyrate (ketones)
Diabetes · also called BHB, 3-hydroxybutyrate, Blood ketones
What it measures
Beta-hydroxybutyrate is the main ketone body produced when fat is burned for energy. Blood BHB is the preferred test to diagnose and monitor diabetic ketoacidosis.
Specimen and preparation
- Specimen: Serum, plasma or capillary whole blood
- Tube: Gold top
- Preparation: Analyse promptly.
Reference range
| Group | Range |
|---|---|
| Normal | <0.6 mmol/L |
| Ketosis | 0.6–1.5 mmol/L |
| High risk of DKA | 1.6–3.0 mmol/L |
| Ketoacidosis likely | >3.0 mmol/L |
Reference ranges differ between laboratories, methods and populations. Always use the range printed on your own lab report.
Causes of high values
- Diabetic ketoacidosis
- Starvation and ketogenic diet
- Alcoholic ketoacidosis
- SGLT2 inhibitors (euglycaemic DKA)
- Prolonged vomiting
Method
Enzymatic (beta-hydroxybutyrate dehydrogenase); point-of-care meters
Good to know
Urine dipsticks detect acetoacetate, not BHB, and may underestimate ketosis early in DKA.
Related tests
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