DKA is the most important and demanding medical emergency within the fields of diabetology and endocrinology. There is no generally accepted definition of DKA and in particular very mild cases may be problematic. As a minimum it seems reasonable to require that pH is below normal range and that levels of ketoacids (ketone bodies) in blood or urine are markedly elevated. As outlined in Table 1 there is a continuous deterioration from clinically insignificant stress ketosis to full blown severe ketoacidosis. In the US population it has been estimated that between 2% and 8% of hospital admissions in children with diabetes are due to DKA  and that the annual incidence rate of DKA in children is around 5 per 1,000 patients .
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