Definition

Diagnosis of DKA is based upon the presence of both biochemical & clinical features[22]:

A) Biochemical criteria[22-25]

• Hyperglycaemia (blood glucose >11 mmol/L)
• Acidosis (pH < 7.3 OR bicarbonate <15 mmol/L)
• Ketosis (blood ketones >3mmol/L or, if blood ketone monitoring is not available, moderate to large ketonuria)

B) Clinical criteria[22]

• Young person who is more than 3% dehydrated
• & or vomiting
• & or drowsy
• & or clinically acidotic

C) Severity of DKA[22,25-26]

• Mild
  • pH <7.3 or serum bicarbonate <15mmol/L
  • Assume to be 5% dehydrated
• Moderate
  • pH <7.2 or serum bicarbonate <10mmol/L
  • Assume to be 7% dehydrated
• Severe
  • pH <7.1 or serum bicarbonate <5mmol/L
  • Assume to be 10% dehydrated

NB: it is not possible to accurately assess the degree of dehydration (& thus fluid deficit) based upon clinical parameters