Patient's question:
Problem Description: Fever, sore throat, pain when urinatingDoctor's answer:
1) Diabetic ketoacidosis: Ketosis is caused by increased fat breakdown leading to higher production of ketones due to reduced glucose utilization. In uncontrolled or improperly treated diabetes, when acidosis or coma occurs, urine ketone testing is of little value. It should be differentiated from hypoglycemia, lactic acidosis due to cardiac or cerebral diseases, or hyperglycemic hyperosmolar diabetic coma. In ketoacidosis, urine ketones are positive, whereas in the latter cases, urine ketone levels are generally not elevated. However, it should be noted that in diabetic ketoacidosis with severe renal impairment and a high renal threshold, urine ketones may decrease or even completely disappear.2) Non-diabetic ketoacidosis: Ketoneuria can occur during feverish stages of infectious diseases such as pneumonia, typhoid, sepsis, or tuberculosis; severe diarrhea, vomiting, starvation, prolonged fasting, or post-syncope. This condition is quite common. Pregnant women often develop ketoneuria due to pregnancy-related symptoms like vomiting, reduced food intake, and significant lipid breakdown, leading to increased metabolic ketone production.
3) Poisoning: Such as after chloroform or ether anesthesia, or phosphorus poisoning.
4) Use of biguanide hypoglycemic drugs: Medications like Glybenclamide can inhibit cellular respiration, resulting in normal blood sugar levels but positive ketoneuria. Urine ketone qualitative tests are often associated with diabetes, pregnancy, malnutrition, or chronic diseases. The results are typically expressed using "plus signs," but instrument measurements often use semi-quantitative expressions, as shown in the table below.
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