Diagnosed when patients exhibit all of the following:

• Hyperglycemia
  • Blood glucose >200 mg/dL
• Metabolic acidosis
  • Venous pH <7.3, or
  • Serum bicarb <15 mEq/L
• Ketosis
  • Presence of ketones in blood or urine
    • Beta-hydroxybutyrate in blood or serum is the most accurate
    • Serum BOHB ≥ 3 mmol/L are present in most children with DKA

Must differentiate from HHS because HHS is associated with more severe dehydration and higher frequency of complications than is typical DKA.