Unknown Diabetes, Hormones & Metabolism NIHR-supported project Digestion, Kidneys & Other Organs

Frequency of Ketosis in People Living with Diabetes or Other Medical Conditions

Funder NIHR (part of DHSC)
Recipient organisation NIHR Leicester Biomedical Research Centre
NIHR support Recorded as supported by this research centre
Period Mar 2025 — Ongoing

In plain English

AI plain-English summary

A sensor strapped to the arm for 15 days will track how often dangerously high ketone levels occur in people with diabetes, heart failure, or chronic kidney disease. Ketones are fat-based fuels the body burns when glucose is scarce. In people with diabetes, a buildup can trigger diabetic ketoacidosis (DKA)—a life-threatening emergency. Drugs called SGLT-2 inhibitors, now widely prescribed for heart failure and kidney disease, also raise ketone risk. Yet no one knows how frequently ketosis actually happens across these patient groups, or which populations face the greatest danger. This exploratory study aims to fill that gap. If the research succeeds, it will identify which patients most need continuous monitoring. That could shift clinical practice from reactive crisis management—rushing people to hospital with DKA—to proactive prevention. The sensor data may eventually guide decisions on who should wear a combined glucose-and-ketone monitor, potentially reducing emergency admissions and improving safety for thousands of NHS patients on SGLT-2 inhibitors. The study is not testing a new treatment; it is gathering fundamental epidemiological data that will shape future monitoring strategies.

View original technical description
Ketone bodies are fat-derived fuels used by tissues for energy when glucose availability is limited, such as during fasting. In people with diabetes, various factors can trigger a build-up of ketones in the blood (ketosis), including inadequate insulin administration, infection, continuous subcutaneous insulin infusion pump failure, and certain medications. This can lead to a life-threatening medical emergency called Diabetic Ketoacidosis (DKA). Patients with heart failure or chronic kidney disease also have an increased risk of ketosis due to the use of SGLT-2 inhibitors for these conditions. The purpose of this exploratory study is to understand the occurrence of ketosis in adult and paediatric people living with diabetes or other medical conditions where the risk of elevated ketones is increased. Data from this study will subsequently inform which populations would benefit from continuous glucose and ketone monitoring. Participants will wear a sensor on the back of their arm for 15 days. The sensor records both glucose and ketone levels and is paired with a smartphone to collect data in a masked mode. The study will be conducted globally, including primary, community, and secondary care NHS sites in the UK.

Researchers

Pratik Choudhary (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

Frequency of Ketosis: Frequency of Ketosis in People Living with Diabetes or Other Medical Conditions.
Oxford Medical Diagnostics: breath acquisition and analysis for non-invasive diabetes testing
Investigating the blood glucose lowering effect of exogenous ketone ingestion in people with type 2 diabetes
Use of capillary blood ketone meters to improve ambulance service care of hyperglycaemic patients: a feasibility study (KARMA2 study)
Myocardial energy starvation and ketone metabolism in patients with type 2 diabetes

Original classification

Lifestyle

Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.