Diabetic ketoacidosis classification
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
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
Classification based on severity
Diabetic ketoacidosis (DKA) may be classified according to severity into the following types:[1][2]
- Mild DKA
- Moderate DKA
- Severe DKA
Shown below is a table summarizing the diagnosis of Diabetic ketoacidosis according the the American Diabetes Association (ADA) guidelines. [3] [4]
| VARIABLE | DIABETIC KETOACIDOSIS | ||
|---|---|---|---|
| MILD (Plasma Glucose > 250mg/dL or 13.88 mmol/L) | MODERATE (Plasma Glucose > 250mg/dL or 13.88 mmol/L) | SEVERE (Plasma Glucose > 250mg/dL or 13.88 mmol/L) | |
| Arterial pH | 7.25 to 7.30 | 7.00 to < 7.24 | < 7.00 |
| Serum bicarbonate | 15 to 18 mEq/L | 10 to < 15 mEq/L | < 10 mEq/L |
| Urine ketone (Nitroprusside reaction method) | Positive | Positive | Positive |
| Serum ketone (Nitroprusside reaction method) | Positive | Positive | Positive |
| Effective serum osmolality | Variable | Variable | Variable |
| Anion gap | > 10 mEq/L (10 mmol/L) | > 12 mEq/L (12 mmol/L) | > 12 mEq/L (12 mmol/L) |
| Mental status | Alert | Alert/drowsy | Stupor/coma |
References
References
- ↑ “Diabetic Ketoacidosis – Endotext – NCBI Bookshelf”.
- ↑ “Diabetic Ketoacidosis – American Family Physician”.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). “Digitoxin metabolism by rat liver microsomes”. Biochem Pharmacol. 24 (17): 1639–41. PMID doi.org/10.2337/dc09-9032 Check
|pmid=value (help). - ↑ Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI; et al. (2001). “Management of hyperglycemic crises in patients with diabetes”. Diabetes Care. 24 (1): 131–53. doi:10.2337/diacare.24.1.131. PMID 11194218.
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