Symptoms are non-specific, and diagnosis can be difficult unless the patient presents with clear indications for arterial blood gas sampling. Symptoms may include:

• Abdominal pain
• Altered appetite (either loss of or increased)
• Altered mental status
• Arrhythmias (ventricular tachycardia), decreased response to epinephrine; both lead to hypotension (low blood pressure).
• Chest pain
• Decreased visual acuity
• Headache
• Kussmaul respirations (deep rapid breathing, classically associated with diabetic ketoacidosis). Rapid deep breaths increase the amount of carbon dioxide exhaled, thus lowering the serum carbon dioxide levels, resulting in some degree of compensation. Over compensation to form a respiratory alkalosis does not occur.
• Lethargy, stupor, coma, seizures.
• Muscle weakness and bone pains
• Nausea, vomiting
• Palpitations
• Weight loss (longer term)