Last reviewed: October 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors

Other diagnostic factors

  • polyuria
  • polyphagia
  • polydipsia
  • weight loss
  • weakness
  • nausea or vomiting
  • abdominal pain
  • dry mucous membranes
  • poor skin turgor
  • sunken eyes
  • tachycardia
  • hypotension
  • Kussmaul respiration
  • acetone breath
  • altered mental status
  • hypothermia

Risk factors

  • inadequate or inappropriate insulin therapy
  • infection
  • MI
  • pancreatitis
  • cerebrovascular accidents
  • acromegaly
  • hyperthyroidism
  • drugs such as corticosteroids, sympathomimetics, thiazides, second-generation antipsychotics, cocaine, or SGLT2 inhibitors
  • Cushing's syndrome
  • Hispanic or black ancestry

Diagnostic investigations

1st investigations to order

  • plasma glucose
  • ABG
  • capillary or serum ketones
  • urinalysis
  • serum urea
  • serum creatinine
  • serum sodium
  • serum potassium
  • serum chloride
  • serum magnesium
  • serum calcium
  • serum phosphate
  • anion gap calculation
  • serum creatine phosphokinase
  • serum lactate
  • LFT
  • serum amylase
  • serum lipase
  • serum osmolality
  • FBC
Full details

Investigations to consider

  • CXR
  • ECG
  • myocardial enzymes
  • blood, urine, or sputum cultures
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Abbas E. Kitabchi

Professor of Medicine and Molecular Sciences

Division of Endocrinology

University of Tennessee

Health Science Center

Memphis

TN

Disclosures

AEK is an author of a number of references cited in this monograph.

Laleh Razavi Nematollahi

Assistant Professor

Division of Endocrinology

Case Western Reserve University

Cleveland

OH

Disclosures

LRN declares that she has no competing interests.

Peer reviewers VIEW ALL

Consultant Physician

Worcestershire Royal Hospital

Worcester

UK

Disclosures

DJ declares that he has no competing interests.

Professor of Medicine

University of Iowa

Iowa City

IA

Disclosures

UMK declares that she has no competing interests.

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