Table 1

Diagnostic criteria for DKA and HHS

DKA
HHS
Mild (plasma glucose >250 mg/dl)Moderate (plasma glucose >250 mg/dl)Severe (plasma glucose >250 mg/dl)Plasma glucose >600 mg/dl
Arterial pH7.25–7.307.00 to <7.24<7.00>7.30
Serum bicarbonate (mEq/l)15–1810 to <15<10>18
Urine ketone*PositivePositivePositiveSmall
Serum ketone*PositivePositivePositiveSmall
Effective serum osmolalityVariableVariableVariable>320 mOsm/kg
Anion gap>10>12>12Variable
Mental statusAlertAlert/drowsyStupor/comaStupor/coma
  • *Nitroprusside reaction method.

  • †Effective serum osmolality: 2[measured Na+ (mEq/l)] + glucose (mg/dl)/18.

  • ‡Anion gap: (Na+) − [(Cl + HCO3 (mEq/l)]. (Data adapted from ref. 13.)