Table 3 Proposed severity stratification for DKA-HHS overlap syndrome
Severity | Acidosis Criteria | Osmolality Criteria | Clinical Context |
|---|---|---|---|
Mild | pH ≥ 7.2 or HCO₃⁻ ≥15 mEq/L | ≤ 320 mOsm/kg | Alert or mildly drowsy |
Moderate | pH 7.1–7.19 or HCO₃⁻ 10-14.9 | 321–350 mOsm/kg | Drowsy but arousable |
Severe | pH < 7.1 or HCO₃⁻ <10 mEq/L | > 350 mOsm/kg | Stupor, coma, and/or evidence of shock or thrombosis |