A diagnosis of diabetic ketoacidosis (DKA) generally begins with a medical history and a physical examination. In addition, a number of blood tests may be performed, including:

• Glucose test. Measures the level of glucose (blood sugar) in a patient’s blood.
  
  
• Electrolyte panel. Measures blood levels of minerals that may be depleted when DKA occurs, such as potassium and sodium. Potassium is an essential mineral important for cellular, neurological and muscular health. Sodium helps the body maintain necessary levels of acids and fluids.
  
  
• Ketone blood test. Measures blood levels of ketones, waste products produced when the body is forced to break down fat to make energy. If people with diabetes have excess ketones in their urine (which can cause nausea and vomiting), it is important for a physician to examine the blood, especially if the patient has vomited more than twice in four hours. Some ketones are released through the urine, but many remain, and these extra ketones build up in the blood and act as a poison to the body.

When checking for ketone levels, the findings are categorized as “small,” “moderate” or “large.” Patients with “moderate” or “large” amounts of ketones and/or high blood glucose should contact their physician. Findings in the negative range are considered normal.

Missed doses of insulin are a common cause of DKA, so physicians are likely to ask questions about the frequency and consistency of doses. When patients regularly take their insulin without skipping any doses, DKA may be caused by a number of underlying illnesses or infections. Additional blood and urine tests may also be taken to diagnose these underlying conditions.

People with diabetes are often advised to monitor their own ketone levels at home, so that DKA can be avoided or diagnosed as soon as possible. Home ketone monitoring involves a urine or blood test. Some glucose meters check ketone levels.

The American Diabetes Association recommends that all pregnant women with diabetes check their ketone levels every day and that all men, women and children with diabetes who are sick have their ketones checked every four hours.