Diabetic Ketoacidosis (DKA) Calculator

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ADA DKA criterion: >250 mg/dL (13.9 mmol/L). Enter the measured serum glucose.
mg/dL
ADA DKA criterion: <7.30. Normal arterial pH is 7.35-7.45.
ADA DKA criterion: <18 mEq/L. Normal serum HCO3 is 22-26 mEq/L.
mEq/L
ADA DKA criterion: positive urine ketones (>= 3 mmol/L) or serum ketones.
Drowsy or stupor/coma indicates moderate or severe DKA regardless of other values.
Used to calculate the anion gap. Normal: 136-145 mEq/L.
mEq/L
Used to calculate the anion gap. Normal: 98-106 mEq/L.
mEq/L
Used to calculate albumin-corrected anion gap. Normal: 3.5-5.0 g/dL. Each 1 g/dL below 4 lowers the AG by ~2.5 mEq/L.
g/dL
Used to estimate effective osmolality. Normal: 7-20 mg/dL.
mg/dL
Any one of: immunosuppression, prior MI, COPD, cirrhosis, CHF, prior stroke. Score: +6.
Severe acidemia at presentation. Score: +4.
Insulin resistance requiring >50 units in first 12 h. Score: +4.
Persistent hyperglycemia 12 hours after admission. Score: +4.
Altered consciousness persisting to 24 hours after admission. Score: +4.
Fever persisting to 24 hours after admission. Score: +3.
DKA DiagnosisDKA: Mild
Confirmed - all 4 ADA criteria met

Confirmed or Not confirmed based on all four ADA criteria

DKA SeverityMild
ADA Criteria Met4/ 4
Anion Gap24mEq/L
Albumin-corrected Anion Gap24mEq/L
Effective Osmolality295.4mOsm/kg
DKA MPM Score0pts
Estimated In-Hospital Mortality0.86% in-hospital mortality (score 0-14)
24 mEq/L
Normal<12Elevated12-20High20+

DKA confirmed - Mild severity (ADA criteria: 4/4)

  • All four ADA criteria are met: glucose >250 mg/dL, ketones present, pH <7.3, and HCO3 <18 mEq/L.
  • Mild DKA: Some patients can be managed in a general ward or even with subcutaneous insulin protocols if no complicating factors are present.
  • Anion gap is elevated at 24.0 mEq/L (>12). Albumin-corrected AG is 24.0 mEq/L. Elevated AG confirms a high-gap metabolic acidosis consistent with DKA.
  • Effective osmolality is 295 mOsm/kg (normal 275-295). Values >320 suggest significant hyperosmolarity.

Next stepNo DKA MPM risk factors are present at this time. Reassess the score at 12 and 24 hours as clinical parameters evolve.

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