Diabetic Ketoacidosis & Hyperosmolar Hyperglycemic State Diagnostics

Laboratory Tests and Ancillaries

Serum glucose, blood urea nitrogen (BUN)/creatinine, serum ketones, electrolytes (anion gap), urinalysis, and ECG and/or chest X-ray (CXR), if indicated should be requested in a patient suspected of diabetic ketoacidosis or hyperosmolar hyperglycemic state. Serum osmolality should be obtained using the formula for effective osmolality, which is (2 × Na) + (glucose/18).  

Other tests that should be requested include urine ketones by dipstick, arterial blood gas, complete blood count (CBC) with differential count, urine, blood, and throat culture, glycosylated hemoglobin (HbA1c), and nitroprusside testing.