Watkins P J, Fitzgerald M G, Malins J M
Br Med J. 1969 Dec 13;4(5684):648-51. doi: 10.1136/bmj.4.5684.648.
A survey of ketonuria in insulin-treated diabetics showed that its significance might vary according to the time of day at which the test was performed. Some of the patients had uncontrolled diabetes in the early morning, when severe hyperglycaemia and hyperketonaemia occurred together, while later during the same day or night an episode of hypoglycaemia caused hyperketonaemia, indicating that too much insulin had been given. Correct assessment of the significance of ketonuria is obviously important, because some patients would probably require a decrease rather than an increase of insulin dosage. Ketonuria does not necessarily indicate impending ketoacidosis.
一项针对接受胰岛素治疗的糖尿病患者的酮尿症调查显示，其意义可能因进行检测的时间不同而有所差异。一些患者在清晨时糖尿病控制不佳，此时会同时出现严重的高血糖和高酮血症，而在同一天或夜晚的晚些时候，一次低血糖发作会导致高酮血症，这表明胰岛素用量过多。正确评估酮尿症的意义显然很重要，因为一些患者可能需要减少而非增加胰岛素剂量。酮尿症不一定预示即将发生酮症酸中毒。
