Diabetic Ketoacidosis Calculator

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis (DKA) is an acute metabolic emergency caused by insulin deficiency, leading to hyperglycemia, ketosis, and metabolic acidosis. The American Diabetes Association (ADA) defines DKA when all four criteria are present: blood glucose above 250 mg/dL (13.8 mmol/L), elevated serum or urine ketones, serum bicarbonate below 18 mEq/L, and arterial pH below 7.30. Use the Anion Gap Calculator to assess the gap component and the Bicarbonate Deficit Calculator when planning IV bicarbonate replacement.

ADA Diagnostic Criteria

All four findings must be present to diagnose DKA: hyperglycemia greater than 250 mg/dL, ketonemia or ketonuria, bicarbonate less than 18 mEq/L, and arterial pH less than 7.30. Euglycemic DKA can occur with glucose at or below 250 mg/dL in pregnancy, SGLT2 inhibitor use, or partial treatment. An elevated anion gap supports the acidosis pattern but is not required for the ADA diagnosis.

DKA Severity Classification

Mild DKA: bicarbonate 15 to 18 mEq/L and pH 7.24 to 7.30 with hyperglycemia and ketosis. Moderate DKA: bicarbonate 10 to less than 15 mEq/L, pH 7.00 to 7.24, elevated anion gap, or drowsiness. Severe DKA: bicarbonate below 10 mEq/L, pH below 7.00, or altered mental status to stupor or coma. Severity guides fluid resuscitation intensity, insulin infusion rate, and ICU admission.