Clinical Manifestations

The clinical manifestations of DKA include [22]:

  • Dehydration
  • Kussmaul respiration (deep, rapid, laboured, can appear like “hyperventilation”)
  • Nausea and vomiting
  • Abdominal pain (can mimic an acute abdomen)
  • Progressive reduction in consciousness, drowsiness and coma
  • Ketotic breath
  • Increased heart rate

Fever is not a feature of DKA.  Think about sepsis in a child or young person with DKA who has any of the following:

  • fever or hypothermia
  • hypotension
  • refractory acidosis
  • lactic acidosis