Diabetic ketoacidosis diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

There is no specific diagnostic study of choice for diabetic ketoacidosis (DKA). There are specific cut-offs for serum glucose level, ketone levels, body pH and serum bicarbonate levels for the diagnosis for diabetic ketoacidosis as outlined by the American Association of Clinical Endocrinologists.

Diagnostic Criteria

The American Association of Clinical Endocrinologists (AACE) states that the diagnosis of DKA is based on the following features/criteria:

Parameter	Lab value
Arterial pH	<7.3
Beta hydroxybutyrate	Children: ≥31 mg/dL (3.0 mmol/L) Adults: ≥40 mg/dL (3.8 mmol/L)
Serum ketones	Positive
Anion gap	> 10
Mental status	Drowsy Stupor Coma in moderate to severe DKA