Diabetic Ketoacidosis (DKA)

Your Path

  • Diabetic Ketoacidosis (DKA)


  • Hyperglyemia from insulin deficiency
  • Often precipitated by another problem--> infection, MI, hypovolemia, poor pos, pancreatitis, meds (steroids), PE, other physiological stress; and/or not taking insulin
  • May also be initial presentation w/type 1 DM
  • Euglycemic DKA: can occur w/sugar < 200, but with all of the other DKA manifestations; Overall, rare; Can occur in Type 1s or Type 2s on SGLT2 inhibitors

Risk Factors

  • Known DM
  • Known poor control
  • Acute other illness that is a precipitant


  • Polyuria, polydypsia
  • Fatigued/feeling poorly to confusion to unarousable

Physical Exam Findings

  • Often ill appearing
  • Tachycardia, and sometimes low BP
  • Tachypnea w/deep breaths (Kussmaul breathing)--> respiratory compensation for metabolic acidosis
  • Sometimes focal findings if there's an underlying physiologic driver (e.g. infection/sepsis, pancreatitis)