History and exam

Other diagnostic factors

common

polyuria

Symptom of hyperglycemia.[1]

polyphagia

Symptom of hyperglycemia.[1]

polydipsia

Symptom of hyperglycemia.[1]

weight loss

Symptom of hyperglycemia.[1]

weakness

Symptom of hyperglycemia.

nausea or vomiting

Abdominal pain, nausea, and vomiting occur in more than 50% of patients with diabetic ketoacidosis.[1] Symptoms correlate with the degree of acidosis and may be confused with acute abdominal crisis.[1]

abdominal pain

Abdominal pain, nausea, and vomiting occur in more than 50% of patients with diabetic ketoacidosis.[1] Symptoms correlate with the degree of acidosis and may be confused with acute abdominal crisis.[1]

dry mucous membranes

Sign of volume depletion.

poor skin turgor

Sign of volume depletion.

sunken eyes

Sign of volume depletion.

tachycardia

Sign of volume depletion.[1]

hypotension

Sign of volume depletion.[1]

Kussmaul respiration

Rapid and deep respiration due to acidosis. Common in diabetic ketoacidosis.[1]

acetone breath

Sign of ketosis. Common in diabetic ketoacidosis.[1]

altered mental status

Mental status may be altered, and varies from alert in mild diabetic ketoacidosis (DKA) to stupor/coma in severe DKA.[1] Studies have shown that acidosis is independently associated with altered sensorium in patients with DKA, but hyperosmolarity and serum ketone levels are not. Combination of hyperosmolarity and acidosis predicts altered sensorium with good sensitivity (61%) and specificity (87%).[74]

不常见

hypothermia

Although concomitant infection is common, patients usually are normothermic or hypothermic due to peripheral vasodilation.[9] Severe hypothermia is a poor prognostic sign.[75]

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