This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diabetic ketoacidosis (DKA) is a serious complication of diabetes. Keto-stix measure urinary acetoacetate but not -Hydroxybutyrate ( -OHB), which is the predominant ketone body in DKA. Laboratory measurement of -OHB is not practical for use in the emergency management of DKA. The Precision Xtra meter is able to test for -OHB in a 10 microliter blood sample, and provides results in 30 seconds. 100 children will be enrolled in this study, which consists of two phases. The first phase will occur at TCH ED. Subjects who are admitted and begin treatment for DKA will be recruited after treatment has begun. An additional 2.5cc of blood will be obtained at each regular blood draw, and be tested for -OHB levels. The lab -OHB levels will be correlated to the values obtained from the Precision Xtra meter. Both of these values will be compared to other clinical indicators of DKA to see how -OHB affects DKA status. Phase two will consist of a one year follow-up with half of the subjects randomized to an experimental group that will have a Precision Xtra meter to track future DKA episodes from home, and the other half serving as controls without the use of this device. The outcome being measured during Phase II is the number of repeat DKA episodes during the one year period.
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