Criteria
Hyperglycemic crises in adults with diabetes: a consensus report[1]
ALL three of the following must be present to make the diagnosis of diabetic ketoacidosis (DKA):
Diabetes or hyperglycemia: glucose ≥200 mg/dL (≥11.1 mmol/L) OR prior history of diabetes
Ketosis: beta-hydroxybutyrate concentration ≥3 mmol/L OR urine ketone strip 2+ or greater
Metabolic acidosis: pH <7.3 and/or bicarbonate concentration <18 mEq/L (<18 mmol/L)
Clinical DKA classification[1]
Not all variables need to be fulfilled for DKA to be defined as mild, moderate or severe.
Mild DKA
Plasma glucose: ≥200 mg/dL (≥11.1 mmol/L)
Arterial pH: >7.25 to <7.30
Serum bicarbonate: 15-18 mEq/L (15-18 mmol/L)
Urine ketone: positive
Serum ketone: beta-hydroxybutyrate 3-6 mmol/L
Mental status: alert
Moderate DKA
Plasma glucose: ≥200 mg/dL (≥11.1 mmol/L)
Arterial pH: 7.00 to 7.25
Serum bicarbonate: 10 to <15 mEq/L (10 to <15 mmol/L)
Urine ketone: positive
Serum ketone: beta-hydroxybutyrate 3-6 mmol/L
Mental status: alert and/or drowsy
Severe DKA
Plasma glucose: ≥200 mg/dL (≥11.1 mmol/L)
Arterial pH: <7.00
Serum bicarbonate: <10 mEq/L (<10 mmol/L)
Urine ketone: positive
Serum ketone: beta-hydroxybutyrate >6 mmol/L
Mental status: stupor and/or coma
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