Table 1 Diagnostic criteria for diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar state (HHS)
DKA
Mild Moderate Severe HHS
Plasma glucose (mmol/l >14 >14 >14 >30 Arterial pH 7.25–7.35 7.0–(7.24 ,7.0 .7.3 Serum bicarbonate (mmol/l) 15–18 10–14 ,10 .15 Urine ketones >++ >++ >++ (+ Plasma ketones >++ >++ >++ (+ Total osmolality (mOsm/kg)* Variable Variable Variable >340 Anion gap .10 .12 .12 ,12 Level of consciousness Alert Alert/drowsy Stupor/coma Stupor/coma
*Formula: 26{[Na+]+[K+]}+[urea]+[glucose]. Formula: [Na+ ]–([Cl2]+[HCO32]) (mmol/l). Table largely adapted from Kitabchi et al.5