Diabetic ketoacidosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]


Patients with diabetic ketoacidosis (DKA) may usually appear cachexic, diaphoretic or obtunded. Physical examination of patients with DKA is usually remarkable for hypothermia, hypotension, tachycardia, tachypnea, kussmaul breathing pattern, acanthosis nigricans, nausea, vomiting and abdominal pain.

Physical Examination

Appearance of the Patient

Patient may look thin, cachexic, ill-appearing, diaphoretic, disoriented or obtunded due to severe hyperglycemia and ketosis.[1]

Vital Signs










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  12. Tuzcu A, Bahceci M, Celen MK, Kilinc N, Ozmen S (2006). "Necrotizing (malignant) otitis externa: an unusual localization of mucormycosis". Indian J Med Microbiol. 24 (4): 289–91. PMID 17185850.
  13. Konstantinov NK, Rohrscheib M, Agaba EI, Dorin RI, Murata GH, Tzamaloukas AH (2015). "Respiratory failure in diabetic ketoacidosis". World J Diabetes. 6 (8): 1009–23. doi:10.4239/wjd.v6.i8.1009. PMC 4515441. PMID 26240698.
  14. Kuppermann N, Park J, Glatter K, Marcin JP, Glaser NS (2008). "Prolonged QT interval corrected for heart rate during diabetic ketoacidosis in children". Arch Pediatr Adolesc Med. 162 (6): 544–9. doi:10.1001/archpedi.162.6.544. PMID 18524745.
  15. Davis SM, Maddux AB, Alonso GT, Okada CR, Mourani PM, Maahs DM (2016). "Profound hypokalemia associated with severe diabetic ketoacidosis". Pediatr Diabetes. 17 (1): 61–5. doi:10.1111/pedi.12246. PMC 4896141. PMID 25430801.
  16. Koektuerk B, Aksoy M, Horlitz M, Bozdag-Turan I, Turan RG (2016). "Role of diabetes in heart rhythm disorders". World J Diabetes. 7 (3): 45–9. doi:10.4239/wjd.v7.i3.45. PMC 4733448. PMID 26862372.
  17. Umpierrez G, Freire AX (2002). "Abdominal pain in patients with hyperglycemic crises". J Crit Care. 17 (1): 63–7. PMID 12040551.
  18. Wyatt LH, Ferrance RJ (2006). "The musculoskeletal effects of diabetes mellitus". J Can Chiropr Assoc. 50 (1): 43–50. PMC 1839979. PMID 17549168.
  19. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (2009). "Hyperglycemic crises in adult patients with diabetes". Diabetes Care. 32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725. PMID 19564476.
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