DKA Severity Classification (ADA)

Plasma Glucose (mg/dL)

Arterial pH

Serum Bicarbonate (mEq/L)

Anion Gap

Mental Status

Protocol Alert:Severe DKA requires immediate ICU admission, aggressive volume resuscitation, and weight-based IV insulin infusion. Monitoring of potassium and mental status is critical.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Patients with triage glucose >250 mg/dL and clinical symptoms of ketoacidosis (nausea, vomiting, abdominal pain, Kussmaul respiration).

To determine the level of patient care (Floor vs. Stepdown vs. ICU).

To guide the intensity of biochemical monitoring and insulin therapy.

How it Works

ADA 2009 Diagnostic Thresholds

Feature	Mild	Moderate	Severe
Plasma Glucose	> 250 mg/dL	> 250 mg/dL	> 250 mg/dL
Arterial pH	7.25 – 7.30	7.00 – < 7.24	< 7.00
Serum Bicarb	15 – 18 mEq/L	10 – < 15 mEq/L	< 10 mEq/L
Ketones	Positive	Positive	Positive
Anion Gap	> 10	> 12	> 12
Mental Status	Alert	Alert/Drowsy	Stupor/Coma

Last Comprehensive Review: 2026

Recent Journal Updates

British J Clinical PharmacologyJul 22, 2026

Comment on ‘Linezolid‐induced lactic acidosis in critically ill patients: A multicentre study of incidence, severity and predictors’

Clinical Context

We think this might be relevant to the clinical guidance for DKA Severity Classification (ADA).

JAMAJul 21, 2026

FDA Approves First Over-the-Counter Continuous Glucose Monitor for Children

Clinical Context

We think this has broad domain relevance to DKA Severity Classification (ADA).

PLOS MedicineJul 13, 2026

Self-explaining artificial intelligence for the classification of B cell non-Hodgkin lymphoma: A diagnostic decision support study

Clinical Context

We think this might be relevant to the clinical guidance for DKA Severity Classification (ADA).

DKA Severity Classification (ADA)

When to Use

When to Use

How it Works

ADA 2009 Diagnostic Thresholds

Clinical Pearls

Critical Caveats

The Gap is Key

Next Steps

Management Priority

The Evidence

Guidelines

Hyperglycemic crises in adult patients with diabetes.

Recent Journal Updates

DKA Severity Classification (ADA)

When to Use

When to Use

How it Works

ADA 2009 Diagnostic Thresholds

Clinical Pearls

Critical Caveats

The Gap is Key

Next Steps

Management Priority

The Evidence

Guidelines

Hyperglycemic crises in adult patients with diabetes.

Recent Journal Updates