Which statement is not a typical factor used to diagnose diabetic ketoacidosis?

Which statement is not a typical factor used to diagnose diabetic ketoacidosis?

• A. Hyperglycemia
• B. Elevated anion gap
• C. Metabolic acidosis
• D. Normal bicarbonate

Answer: (D)

In DKA the body runs on stress hormones with insulin deficiency, driving ketone production and leading to anion gap metabolic acidosis. The acids accumulate and bicarbonate is used to buffer them, so the serum bicarbonate level falls. That means you typically see low bicarbonate, not normal. Hyperglycemia and an elevated anion gap metabolic acidosis with ketones are characteristic, and the low bicarbonate helps reflect the degree of acidosis. So a normal bicarbonate would not fit the usual DKA pattern, making it the not-typical factor.

In DKA the body runs on stress hormones with insulin deficiency, driving ketone production and leading to anion gap metabolic acidosis. The acids accumulate and bicarbonate is used to buffer them, so the serum bicarbonate level falls. That means you typically see low bicarbonate, not normal. Hyperglycemia and an elevated anion gap metabolic acidosis with ketones are characteristic, and the low bicarbonate helps reflect the degree of acidosis. So a normal bicarbonate would not fit the usual DKA pattern, making it the not-typical factor.