Diabetic ketoacidosis classification
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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
Diabetic ketoacidosis (DKA) may be classified according to severity into mild, moderate and severe DKA. The classification takes into account various parameters for example, arterial pH, anion gap, effective serum osmolarity, mental status, serum bicarbonate levels and serum ketone levels. Classification of DKA has important implications in the management of the disease.
Classification
Classification based on severity
Diabetic ketoacidosis (DKA) may be classified according to severity into the following types:[1]
- Mild DKA
- Moderate DKA
- Severe DKA
| VARIABLE | DIABETIC KETOACIDOSIS | ||
|---|---|---|---|
| MILD (SERUM GLUCOSE > 250 MG PER DL [13.88 MMOL PER L]) | MODERATE (SERUM GLUCOSE > 250 MG PER DL) | SEVERE (SERUM GLUCOSE > 250 MG PER DL) | |
| Anion gap | > 10 mEq per L (10 mmol per L) | > 12 mEq per L (12 mmol per L) | > 12 mEq per L (12 mmol per L) |
| Arterial pH | 7.24 to 7.30 | 7.00 to < 7.24 | < 7.00 |
| Effective serum osmolality | Variable | Variable | Variable |
| Mental status | Alert | Alert/drowsy | Stupor/coma |
| Serum bicarbonate | 15 to 18 mEq per L (15 to 18 mmol per L) | 10 to < 15 mEq per L (10 to < 15 mmol per L) | < 10 mEq per L (10 mmol per L) |
| Serum ketones | Positive | Positive | Positive |