Editing Diabetic ketoacidosis (section)

===Criteria===
Diabetic ketoacidosis is distinguished from other diabetic emergencies by the presence of large amounts of ketones in blood and urine, and marked metabolic acidosis. [[Nonketotic hyperosmolar coma|Hyperosmolar hyperglycemic state]] (HHS, sometimes labeled "hyperosmolar non-ketotic state" or HONK) is much more common in type 2 diabetes and features increased [[plasma osmolarity]] (above 320&nbsp;mosm/kg) due to profound dehydration and concentration of the blood; mild acidosis and ketonemia may occur in this state, but not to the extent observed in DKA. There is a degree of overlap between DKA and HHS, as in DKA the osmolarity may also be increased.<ref name=ADA2009/>

[[Ketoacidosis]] is not always the result of diabetes. It may also result from [[alcoholic beverage|alcohol excess]] and from [[starvation]]; in both states the glucose level is normal or low. [[Metabolic acidosis]] may occur in people with diabetes for other reasons, such as [[poison]]ing with [[ethylene glycol]] or [[paraldehyde]].<ref name=ADA2009/>

The [[American Diabetes Association]] categorizes DKA in adults into one of three stages of severity:<ref name=ADA2009/>
* ''Mild:'' blood pH mildly decreased to between 7.25 and 7.30 (normal 7.35–7.45); serum [[bicarbonate]] decreased to 15–18&nbsp;mmol/L (normal above 20); the person is alert
* ''Moderate:'' pH 7.00–7.25, bicarbonate 10–15, mild drowsiness may be present
* ''Severe:'' pH below 7.00, bicarbonate below 10, stupor or coma may occur

A 2004 statement by the European Society for Paediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society (for children) uses slightly different cutoffs, where mild DKA is defined by pH&nbsp;7.20–7.30 (bicarbonate 10–15&nbsp;mmol/L), moderate DKA by pH&nbsp;7.1–7.2 (bicarbonate 5–10) and severe DKA by pH<7.1 (bicarbonate below 5).<ref name=ESPE/>