What defines euglycemic diabetic ketoacidosis (DKA)?

What defines euglycemic diabetic ketoacidosis (DKA)?

• A. Hyperglycemia above 300 mg/dL with ketosis
• B. Blood glucose below 250 mg/dL with ketoacidosis.
• C. No ketones with dehydration
• D. Hyperglycemic coma

Answer: (B)

Euglycemic DKA means you can have the dangerous ketoacidosis picture without the usual high blood glucose. The defining feature is metabolic acidosis with elevated ketones, but the glucose level is not markedly elevated—often below 250 mg/dL (and can be near normal). That’s why the statement describing blood glucose under 250 mg/dL together with ketoacidosis best captures this scenario. The other descriptions don’t fit: classic DKA typically involves higher glucose, dehydration with no ketosis isn’t DKA, and a hyperglycemic coma implies markedly elevated glucose with altered consciousness but not necessarily ketoacidosis. In practice, euglycemic DKA is a reminder to assess for ketones and acidosis even when glucose isn’t high, and to manage with fluids, insulin, and electrolyte correction as needed.

Euglycemic DKA means you can have the dangerous ketoacidosis picture without the usual high blood glucose. The defining feature is metabolic acidosis with elevated ketones, but the glucose level is not markedly elevated—often below 250 mg/dL (and can be near normal). That’s why the statement describing blood glucose under 250 mg/dL together with ketoacidosis best captures this scenario.

The other descriptions don’t fit: classic DKA typically involves higher glucose, dehydration with no ketosis isn’t DKA, and a hyperglycemic coma implies markedly elevated glucose with altered consciousness but not necessarily ketoacidosis. In practice, euglycemic DKA is a reminder to assess for ketones and acidosis even when glucose isn’t high, and to manage with fluids, insulin, and electrolyte correction as needed.