DKA vs HHS Classification + DKA Severity (ADA)
DKA / HHS classifier (ADA 2009): grades diabetic ketoacidosis by pH / bicarbonate and screens for the hyperosmolar hyperglycemic state, reporting the anion gap and effective serum osmolality.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Serum glucose
- 520 mg/dL
- Arterial / venous pH
- 6.95
- Serum bicarbonate
- 6 mEq/L
- β-hydroxybutyrate
- 6 mmol/L
- Mental status
- Stupor / coma
- Serum sodium
- 130 mEq/L
- Serum chloride
- 95 mEq/L
Result: DKA, severe grade; anion gap 29 mEq/L, effective osmolality 289 mOsm/kg.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- DKA
- Hyperglycemia (glucose ≥ 250) + acidosis (pH < 7.30, HCO3 < 18) + ketosis. Graded mild (pH 7.25–7.30, HCO3 15–18), moderate (pH 7.00–7.24, HCO3 10–14), severe (pH < 7.00, HCO3 < 10).
- HHS
- Glucose > 600, effective osmolality > 320 mOsm/kg, pH > 7.30, HCO3 > 18, minimal ketosis.
- Mixed
- Both the ketoacidosis and the hyperosmolar criteria are met together.
What you enter
- Serum glucose
- Arterial / venous pH
- Serum bicarbonate
- β-hydroxybutyrate
- Mental status
- Serum sodium
- Serum chloride
How this is calculated
Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335-1343. Diagnostic thresholds reconciled to the 2024 ADA/EASD hyperglycemic-crises consensus (Umpierrez GE, et al. Diabetes Care. 2024). Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.