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Table 1—

Diagnostic criteria for DKA and HHS

DKA
HHS
MildModerateSevere
Plasma glucose (mg/dl) >250 >250 >250 >600 
Arterial pH 7.25–7.30 7.00–7.24 <7.00 >7.30 
Serum bicarbonate (mEq/l) 15–18 10 to <15 <10 >15 
Urine ketones* Positive Positive Positive Small 
Serum ketones* Positive Positive Positive Small 
Effective serum osmolality (mOsm/kg) Variable Variable Variable >320 
Anion gap >10 >12 >12 Variable 
Alteration in sensoria or mental obtundation Alert Alert/drowsy Stupor/coma Stupor/coma 
DKA
HHS
MildModerateSevere
Plasma glucose (mg/dl) >250 >250 >250 >600 
Arterial pH 7.25–7.30 7.00–7.24 <7.00 >7.30 
Serum bicarbonate (mEq/l) 15–18 10 to <15 <10 >15 
Urine ketones* Positive Positive Positive Small 
Serum ketones* Positive Positive Positive Small 
Effective serum osmolality (mOsm/kg) Variable Variable Variable >320 
Anion gap >10 >12 >12 Variable 
Alteration in sensoria or mental obtundation Alert Alert/drowsy Stupor/coma Stupor/coma 
*

Nitroprusside reaction method;

calculation: 2[measured Na (mEq/l)] + glucose (mg/dl)/18;

calculation: (Na+) − (Cl + HCO3) (mEq/l). See text for details.

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