DKA Severity Classification
Classifies diabetic ketoacidosis severity using pH, bicarbonate, and blood ketone levels.
Score interpretation
Criteria suggest mild or no DKA. Confirm with clinical picture and urine ketones.
→ If DKA suspected despite mild biochemistry: fixed-rate IV insulin infusion (FRIII) 0.1 units/kg/hr. Fluid resuscitation. Check glucose hourly.
Mild to moderate DKA. pH 7.25–7.30, HCO₃ 15–18, ketones 3–6 mmol/L.
→ JBDS DKA protocol: IV 0.9% NaCl + FRIII (0.1 units/kg/hr). Monitor hourly glucose/ketones. Senior review. Target: ketones fall ≥0.5 mmol/L/hr.
Severe DKA. pH < 7.00 or HCO₃ < 10 mmol/L or ketones ≥ 6 mmol/L.
→ URGENT senior/HDU. Aggressive fluid resuscitation. FRIII. K⁺ replacement (if K⁺ ≥3.5 and making urine). Consider HDU/ICU. Look for precipitant.
Interpretation bands for the DKA Severity. Apply clinical judgement and local guidance.
References
- Joint British Diabetes Societies (JBDS) Inpatient Care Group. Management of Diabetic Ketoacidosis in Adults. 2023.
Related
Curated clinical cross-links plus same-class fallbacks.
- Sodium Bicarbonate · Alkalising Agent / Electrolyte
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Bicarbonate 8.4% · Electrolyte Buffer
- Sodium bicarbonate with sodium chloride · Alkalinising IV solution
- Insulin (Soluble / Actrapid) · Insulin
- Insulin Glargine · Long-Acting Insulin Analogue (Basal)
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.