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Spontaneous ketonuria and risk of incident diabetes: a 12 year prospective study – published online 20/02/2019

Fig from Kim paper

Gyuri Kim, Sang-Guk Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Ele Ferrannini, Yong-ho Lee, Nam H. Cho

Ketones are regarded as a thrifty fuel for peripheral tissues, but the clinical and prognostic significance of mild ketosis is still uncertain. In this issue, Kim and colleagues (https://doi.org/10.1007/s00125-019-4829-x) investigated the association between spontaneous fasting ketonuria and incident diabetes in conjunction with changes in metabolic variables in a large population-based, observational study. During 12 years of follow-up, individuals with fasting ketonuria at baseline maintained lower post-load 1 h and 2 h glucose levels and a higher insulinogenic index, even though the groups with and without ketonuria had comparable baseline values. Individuals with spontaneous fasting ketonuria at baseline had a significantly lower risk of incident diabetes compared with individuals without ketonuria, independently of other metabolic variables. The authors suggest that spontaneous fasting ketonuria may be a novel signature in the modulation of glucose metabolism and may have the potential to prevent diabetes.

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