Table 1—

Diagnostic criteria and typical total body deficits of water and electrolytes in DKA and HHS

DKA
HHS
MildModerateSevere
Diagnostic criteria and classification
    Plasma glucose (mg/dl)>250 mg/dl>250 mg/dl>250 mg/dl>600 mg/dl
    Arterial pH7.25–7.307.00 to <7.25<7.00>7.30
    Serum bicarbonate (mEq/l)15–1810 to <15<10>15
    Urine ketone*PositivePositivePositiveSmall
    Serum ketone*PositivePositivePositiveSmall
    Effective serum osmolalityVariableVariableVariable>320 mOsm/kg
    Anion gap>10>12>12<12
    Mental statusAlertAlert/drowsyStupor/comaStupor/coma
Typical deficits
    Total water (l)69
    Water (ml/kg)§100100–200
    Na+ (mEq/kg)7–105–13
    Cl (mEq/kg)3–55–15
    K+ (mEq/kg)3–54–6
    PO4 (mmol/kg)5–73–7
    Mg++ (mEq/kg)1–21–2
    Ca++ (mEq/kg)1–21–2
  • *

    * Nitroprusside reaction method.

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

  • Calculation of anion gap: (Na+) − [Cl + HC03 (mEq/l)].

  • §

    § Per kg body wt. Data adapted from refs. 1, 4, and 7.