Editing Diabetic ketoacidosis (section)

===Investigations===
Diabetic ketoacidosis may be diagnosed when the combination of [[hyperglycemia]] (high blood sugars), ketones in the blood or on [[urinalysis]] and acidosis are demonstrated.<ref name=JBDS/> In about 10% of cases the blood sugar is not significantly elevated ("euglycemic diabetic ketoacidosis").<ref name=ADA2009/>

A pH measurement is performed to detect acidosis. Blood from a [[vein]] is adequate, as there is little difference between the arterial and the venous pH; arterial samples are only required if there are concerns about oxygen levels.<ref name=JBDS/> Ketones can be measured in the urine (acetoacetate) and blood (β-hydroxybutyrate). When compared with urine acetoacetate testing, capillary blood β-hydroxybutyrate determination can reduce the need for admission, shorten the duration of hospital admission and potentially reduce the costs of hospital care.<ref>{{cite journal | vauthors = Klocker AA, Phelan H, Twigg SM, Craig ME | title = Blood β-hydroxybutyrate vs. urine acetoacetate testing for the prevention and management of ketoacidosis in Type 1 diabetes: a systematic review | journal = Diabetic Medicine | volume = 30 | issue = 7 | pages = 818–824 | date = July 2013 | pmid = 23330615 | doi = 10.1111/dme.12136 | s2cid = 22070325 }}</ref> At very high levels, capillary blood ketone measurement becomes imprecise.<ref name=Misra2015>{{cite journal | vauthors = Misra S, Oliver NS | title = Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis | journal = Diabetic Medicine | volume = 32 | issue = 1 | pages = 14–23 | date = January 2015 | pmid = 25307274 | doi = 10.1111/dme.12604 | s2cid = 11923923 }}</ref>

In addition to the above, blood samples are usually taken to measure [[urea]] and [[creatinine]] (measures of [[renal function|kidney function]], which may be impaired in DKA as a result of dehydration) and electrolytes. Furthermore, markers of infection ([[complete blood count]], [[C-reactive protein]]) and [[acute pancreatitis]] ([[amylase]] and [[lipase]]) may be measured. Given the need to exclude infection, [[chest X-ray|chest radiography]] and urinalysis are usually performed.<ref name=ADA2009/>

If cerebral edema is suspected because of confusion, recurrent vomiting or other symptoms, [[computed tomography]] may be performed to assess its severity and to exclude other causes such as [[stroke]].<ref name=Brown2004/>