Which statement best describes the diagnostic criteria for diabetic ketoacidosis?

Which statement best describes the diagnostic criteria for diabetic ketoacidosis?

• A. Glucose > 250 mg/dL; anion gap > 10-12 mEq/L; bicarbonate < 15 mEq/L; pH < 7.3; ketonuria or ketonemia
• B. Glucose > 200 mg/dL; anion gap < 8; bicarbonate > 20; pH > 7.35
• C. Glucose > 300 mg/dL; anion gap 8; bicarbonate 20; pH 7.4
• D. Glucose > 150 mg/dL; no ketones; pH 7.3

Answer: (A)

In diabetic ketoacidosis you expect a combination of high blood sugar, a high anion gap metabolic acidosis, and the presence of ketones. The typical diagnostic picture includes glucose commonly above 250 mg/dL, a metabolic acidosis with a bicarbonate low (often below 18 mEq/L and frequently under 15), an arterial pH in the acid range (usually below 7.3), and ketones detected in serum or urine. The statement that best fits this pattern has glucose over 250 mg/dL, an elevated anion gap, bicarbonate under 15, a pH under 7.3, and ketones present. That combination captures the essential triad: hyperglycemia, metabolic acidosis with bicarbonate depletion, and ketosis. Why the others aren’t correct: they either show no significant acidosis (pH not depressed and bicarbonate not low), or they lack ketones altogether, or they have only modest hyperglycemia without the ketoacidosis component. All of those would be inconsistent with diabetic ketoacidosis.

In diabetic ketoacidosis you expect a combination of high blood sugar, a high anion gap metabolic acidosis, and the presence of ketones. The typical diagnostic picture includes glucose commonly above 250 mg/dL, a metabolic acidosis with a bicarbonate low (often below 18 mEq/L and frequently under 15), an arterial pH in the acid range (usually below 7.3), and ketones detected in serum or urine.

The statement that best fits this pattern has glucose over 250 mg/dL, an elevated anion gap, bicarbonate under 15, a pH under 7.3, and ketones present. That combination captures the essential triad: hyperglycemia, metabolic acidosis with bicarbonate depletion, and ketosis.

Why the others aren’t correct: they either show no significant acidosis (pH not depressed and bicarbonate not low), or they lack ketones altogether, or they have only modest hyperglycemia without the ketoacidosis component. All of those would be inconsistent with diabetic ketoacidosis.