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
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.