Which laboratory value supports the presence of metabolic acidosis in diabetic ketoacidosis?

Which laboratory value supports the presence of metabolic acidosis in diabetic ketoacidosis?

• A. Bicarbonate < 15 mEq/L
• B. Bicarbonate > 25 mEq/L
• C. pH > 7.4
• D. Anion gap < 8

Answer: (A)

Metabolic acidosis in diabetic ketoacidosis shows up as a reduced bicarbonate because the ketoacids produced are buffered by bicarbonate, consuming it in the process. A bicarbonate level well below normal, such as less than 15 mEq/L, is a clear laboratory sign of metabolic acidosis and helps gauge severity. In DKA you’d also expect a low pH and an elevated anion gap from the ketoacids; options indicating a bicarbonate above 25, a pH above 7.4, or an anion gap below 8 would not fit the typical picture of DKA.

Metabolic acidosis in diabetic ketoacidosis shows up as a reduced bicarbonate because the ketoacids produced are buffered by bicarbonate, consuming it in the process. A bicarbonate level well below normal, such as less than 15 mEq/L, is a clear laboratory sign of metabolic acidosis and helps gauge severity. In DKA you’d also expect a low pH and an elevated anion gap from the ketoacids; options indicating a bicarbonate above 25, a pH above 7.4, or an anion gap below 8 would not fit the typical picture of DKA.