DKA / HHS Diagnosis and Initial Management — free guideline decision tool
Discriminate DKA from HHS by glucose, blood gas, ketones and osmolality, and grade DKA severity, with the fluid/insulin/potassium plan. Instant, browser-side.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Glucose | 28 mmol/L |
|---|---|
| Arterial pH | 7.15 |
| HCO₃⁻ | 12 mmol/L |
| Blood ketones ≥ 3 or urine ketones moderate-large | Yes |
| Effective plasma osmolality (optional) | 330 mOsm/kg |
→AssessmentDKA with hyperosmolarity (mixed)
- Diagnostic points：DKA: glucose > 13.9 + blood/urine ketones positive + pH < 7.3 or HCO₃⁻ < 18; HHS: glucose ≥ 33.3 + effective osmolality > 320 + pH > 7.3, HCO₃⁻ > 18, no significant ketosis
- Fluids：HHS has greater water deficit and needs larger volumes
- Insulin：when glucose reaches [pending update](DKA)/[pending update] (HHS) switch to dextrose-containing fluid and reduce to 0.02–0.05
| Glucose | 28 mmol/L |
|---|---|
| Arterial pH | 7.15 |
| HCO₃⁻ | 12 mmol/L |
| Blood ketones ≥ 3 or urine ketones moderate-large | No/weak |
| Effective plasma osmolality (optional) | 330 mOsm/kg |
→AssessmentDoes not meet typical DKA/HHS criteria — re-evaluate clinically
- Diagnostic points：DKA: glucose > 13.9 + blood/urine ketones positive + pH < 7.3 or HCO₃⁻ < 18; HHS: glucose ≥ 33.3 + effective osmolality > 320 + pH > 7.3, HCO₃⁻ > 18, no significant ketosis
- Fluids：HHS has greater water deficit and needs larger volumes
- Insulin：when glucose reaches [pending update](DKA)/[pending update] (HHS) switch to dextrose-containing fluid and reduce to 0.02–0.05
Common questions
What is DKA / HHS Diagnosis and Initial Management?
Discriminate DKA from HHS by glucose, blood gas, ketones and osmolality, and grade DKA severity, with the fluid/insulin/potassium plan. Instant, browser-side.
How is DKA / HHS Diagnosis and Initial Management calculated? What is the core formula?
DKA: glucose > 13.9 + ketones positive + pH < 7.3 or HCO₃⁻ < 18; severity by pH/HCO₃⁻ (mild 7.25–7.30 / 15–18, moderate 7.0–7.24 / 10–15, severe < 7.0 / < 10). HHS: glucose ≥ 33.3 + effective osmolality > 320 + no significant acidosis/ketosis. The two can coexist.
When is DKA / HHS Diagnosis and Initial Management used?
Initial assessment and management framing of diabetic ketoacidosis and the hyperglycemic hyperosmolar state.
What are the key clinical points for DKA / HHS Diagnosis and Initial Management?
HHS needs larger volumes. add dextrose and reduce the rate once glucose reaches [pending update](DKA) / [pending update](HHS). Potassium: replace if K < 5.2 with adequate urine output; if K < 3.3 give potassium first and withhold insulin until ≥ 3.3. Bicarbonate generally not given (consider only pH < 7.0); always find and treat the trigger (infection most common).
What are the limits and cautions when using DKA / HHS Diagnosis and Initial Management?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does DKA / HHS Diagnosis and Initial Management upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is DKA / HHS Diagnosis and Initial Management calculated in practice? Can you show a worked example?
Inputs: Glucose 28 mmol/L, Arterial pH 7.15, HCO₃⁻ 12 mmol/L, Blood ketones ≥ 3 or urine ketones moderate-large Yes, Effective plasma osmolality (optional) 330 mOsm/kg → Result: Assessment DKA with hyperosmolarity (mixed)（Diagnostic points: DKA: glucose > 13.9 + blood/urine ketones positive + pH < 7.3 or HCO₃⁻ < 18; HHS: glucose ≥ 33.3 + effective osmolality > 320 + pH > 7.3, HCO₃⁻ > 18, no significant ketosis, Fluids: HHS has greater water deficit and needs larger volumes, Insulin: when glucose reaches [pending update](DKA)/[pending update] (HHS) switch to dextrose-containing fluid and reduce to 0.02–0.05） Inputs: Glucose 28 mmol/L, Arterial pH 7.15, HCO₃⁻ 12 mmol/L, Blood ketones ≥ 3 or urine ketones moderate-large No/weak, Effective plasma osmolality (optional) 330 mOsm/kg → Result: Assessment Does not meet typical DKA/HHS criteria — re-evaluate clinically（Diagnostic points: DKA: glucose > 13.9 + blood/urine ketones positive + pH < 7.3 or HCO₃⁻ < 18; HHS: glucose ≥ 33.3 + effective osmolality > 320 + pH > 7.3, HCO₃⁻ > 18, no significant ketosis, Fluids: HHS has greater water deficit and needs larger volumes, Insulin: when glucose reaches [pending update](DKA)/[pending update] (HHS) switch to dextrose-containing fluid and reduce to 0.02–0.05）
Run DKA / HHS Diagnosis and Initial Management now
Discriminate DKA from HHS by glucose, blood gas, ketones and osmolality, and grade DKA severity, with the fluid/insulin/potassium plan. Instant, browser-side.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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