DKA Resolution Criteria
Applies the published criteria for resolution of diabetic ketoacidosis.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Glucose, mg/dL
- 180 mg/dL
- Serum bicarbonate, mEq/L
- 16 mEq/L
- Venous pH
- 7.34
- Anion gap, mEq/L
- 10 mEq/L
Result: resolved: a glucose of 180 with 3 of the three met
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Resolved
- A glucose below 200 mg/dL together with at least two of a bicarbonate at or above 15 mEq/L, a venous pH above 7.30, and an anion gap at or below 12 mEq/L.
- Not the glucose
- A normal glucose is one of four conditions. Stopping the infusion when it falls is the commonest way rebound ketoacidosis happens: the infusion closes the gap, and the glucose falls first.
- Two of three
- Not all three. A patient whose gap and bicarbonate have come back still qualifies while the venous pH lags, because resuscitation fluid leaves a hyperchloremic acidosis behind.
- A closed gap alone
- One of three, and not enough on its own.
- The anion gap, not ketones
- The nitroprusside reaction misses beta-hydroxybutyrate, the dominant ketone early, so measured ketones can appear to rise as a patient improves.
- After resolution
- Subcutaneous insulin is given and overlapped with the infusion, conventionally by 1 to 2 hours, before the infusion comes down.
What you enter
- Glucose, mg/dL (resolution needs it below 200)
- Serum bicarbonate, mEq/L (met at 15 or above)
- Venous pH (met above 7.30)
- Anion gap, mEq/L (met at 12 or below; this is the variable that tracks the ketosis)
How this is calculated
Citation
Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335-1343. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.