The most common cause of an episode of DKA is idiopathic.
The level of consciousness of the patient correlates well with the severity of the acidosis and hyperglycemia.
For every 180 mg/dL rise in the serum glucose, the measured serum sodium decreases by approximately 5 mEq/mL.
Glucagon and other hormones probably have no importance in the genesis of DKA.
Normothermic patients do not require evaluation of infection.
Infection is the most common cause of diabetic ketoacidosis, yet most patients with diabetic ketoacidosis and infection have a normal body temperature. While other stresses (pregnancy, surgery, and myocardial infarction) can precipitate DKA, infection must be presumed regardless of the patient's temperature. The level of consciousness has no correlation with the severity of any biochemical abnormality except the serum osmolality. Altered mental status is likely to be present with osmolality >340 mOsm/kg. Nausea, abdominal pain, and other gastrointestinal complaints are commonly seen in patients with DKA and serve as a source of confusion when evaluating for signs of precipitating infection or illness. In general, abdominal symptoms that are a result of the DKA resolve as treatment progresses. A dilutional effect in serum sodium occurs with hyperglycemia. However, significant hypokalemia, hypomagnesemia, and hypochloremia are frequent findings in DKA.