Based on ADA Guidelines for severity classification.
Typically > 250 mg/dL in DKA
Normal range: 7.35 – 7.45
Normal range: 22 – 28 mEq/L
Alert
Alert / Drowsy
Stupor / Coma
Results
Anion Gap:–
Likely DKA Classification:–
CRITICAL WARNING: This tool is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Diabetic Ketoacidosis is a life-threatening medical emergency. If you suspect DKA, call emergency services immediately.
Understanding Diabetic Ketoacidosis (DKA)
Diabetic Ketoacidosis (DKA) is a serious and potentially life-threatening complication of diabetes, most commonly associated with Type 1 diabetes, though it can occur in Type 2 diabetes. It happens when the body does not have enough insulin to allow blood sugar into your cells for use as energy.
Instead, the liver breaks down fat for fuel, a process that produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body.
Anion Gap Calculation
A critical component in diagnosing DKA is the calculation of the Anion Gap. This value represents the difference between the primary measured cations (positive ions) and the primary measured anions (negative ions) in the serum.
A normal anion gap is typically considered to be between 8 and 12 mEq/L. In DKA, the accumulation of ketoacids (beta-hydroxybutyrate and acetoacetate) leads to a high anion gap metabolic acidosis, typically greater than 10-12 mEq/L.
DKA Severity Classification Guidelines
The American Diabetes Association (ADA) classifies DKA severity into three categories based on arterial pH, serum bicarbonate levels, the anion gap, and the patient's mental status.
Parameter
Mild DKA
Moderate DKA
Severe DKA
Arterial pH
7.25 – 7.30
7.00 – 7.24
< 7.00
Serum Bicarbonate (mEq/L)
15 – 18
10 – < 15
< 10
Anion Gap
> 10
> 12
> 12
Mental Status
Alert
Alert/Drowsy
Stupor/Coma
How to Use This Calculator
Blood Glucose: Enter the current blood glucose level. While DKA typically presents with glucose > 250 mg/dL, "Euglycemic DKA" can occur with lower levels, especially with SGLT2 inhibitors.
Arterial pH: Enter the pH value from an arterial blood gas (ABG) analysis.
Serum Bicarbonate: Enter the HCO3- level from the metabolic panel.
Electrolytes (Na+ and Cl-): Required to calculate the Anion Gap.
Mental Status: Assessment of the patient's consciousness level aids in classification.
function calculateDKA() {
// 1. Retrieve Input Values
var glucose = parseFloat(document.getElementById('inputGlucose').value);
var ph = parseFloat(document.getElementById('inputPh').value);
var hco3 = parseFloat(document.getElementById('inputHco3').value);
var na = parseFloat(document.getElementById('inputNa').value);
var cl = parseFloat(document.getElementById('inputCl').value);
var mental = document.getElementById('inputMental').value;
// 2. DOM Elements for Output
var resultBox = document.getElementById('resultBox');
var displayAG = document.getElementById('displayAnionGap');
var displaySev = document.getElementById('displaySeverity');
// 3. Validation
if (isNaN(glucose) || isNaN(ph) || isNaN(hco3) || isNaN(na) || isNaN(cl)) {
alert("Please enter valid numerical values for all lab fields.");
return;
}
// 4. Calculate Anion Gap
// Formula: Na – (Cl + HCO3)
var anionGap = na – (cl + hco3);
// 5. Determine Severity Logic (Based on ADA Guidelines)
var severityText = "Not suggestive of DKA";
var severityClass = "severity-none";
// Criteria check flags
// Note: Glucose > 250 is standard, but we focus on Acidosis severity here if DKA is suspected
// The core classification relies on pH and Bicarbonate
// Check Severe
if (ph < 7.00 || hco3 12) {
severityText = "Severe DKA";
severityClass = "severity-severe";
}
}
// Check Moderate (If not already Severe)
else if ((ph >= 7.00 && ph = 10 && hco3 12) {
severityText = "Moderate DKA";
severityClass = "severity-moderate";
}
}
// Check Mild (If not Severe or Moderate)
else if ((ph >= 7.25 && ph = 15 && hco3 10) {
severityText = "Mild DKA";
severityClass = "severity-mild";
}
}
// Additional Check: If Glucose is very low, warn user (optional, but keeping logic strict to DKA criteria)
if (glucose < 250 && severityText.includes("DKA")) {
severityText += " (Note: Glucose < 250 mg/dL, consider Euglycemic DKA)";
}
// If Anion gap is normal (<10), likely not DKA despite pH
if (anionGap 7.30 && hco3 > 18 && anionGap <= 12) {
severityText = "Values within normal limits / Not DKA";
severityClass = "severity-none";
}
// 6. Display Results
displayAG.innerText = anionGap.toFixed(1) + " mEq/L";
displaySev.innerText = severityText;
// Reset classes
displaySev.className = "dka-severity-badge";
displaySev.classList.add(severityClass);
resultBox.style.display = "block";
// Smooth scroll to result
resultBox.scrollIntoView({ behavior: 'smooth', block: 'nearest' });
}