UMMS Affiliation

Department of Pathology, UMass Memorial Medical Center

Publication Date


Document Type



Analytical, Diagnostic and Therapeutic Techniques and Equipment | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Nutritional and Metabolic Diseases | Pathology


Objective: To determine if bicarbonate values from venous blood gas (VBG) and plasma chemistry samples provided agreement in determining the bicarbonate criteria for the diagnosis and/or resolution of diabetic ketoacidosis (DKA).

Methods: A retrospective chart review of data from patients admitted to a tertiary care hospital with a diagnosis of DKA over a four year period was performed. Paired bicarbonate values from a VBG and chemistry panel, if drawn within 60minutes of each other, were compared.

Results: At the time of diagnosis of DKA, 197 paired bicarbonate values were available for analysis with the mean difference between the two methods of testing of 2.5mmol/L. 16 of the 197 (8%) paired values were discordant in meeting criteria for diagnosis of DKA. At the time of resolution of DKA, 83 paired bicarbonate samples were compared. The mean difference was 2.3mmol/L. 20 of the 83 (24%) paired bicarbonate values showed discordance with regards to meeting the bicarbonate criteria for resolution of DKA.

Conclusion: Discordance between bicarbonate results from different analysis methods may lead to different determinations as to whether or not a patient meets the biochemical definition for diagnosis and resolution of DKA.


diabetic ketoacidosis, diagnosis, bicarbonate values

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© 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (

DOI of Published Version



J Clin Transl Endocrinol. 2019 Aug 16;18:100205. doi: 10.1016/j.jcte.2019.100205. eCollection 2019 Dec. Link to article on publisher's site

Journal/Book/Conference Title

Journal of clinical and translational endocrinology

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.