1st order laboratory parameters – obligatory laboratory tests.
- Small blood count [Hk↑ due to dehydration (lack of fluid) and hyperglycemia (high blood sugar) in coma diabeticum]
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
- Electrolytes – potassium, sodium [note: insulin intake lowers potassium levels].
- Glucose (blood sugar)
- Ketone concentration in the blood
- Blood gas analysis (BGA)
- Small blood count
- Thyroid parameters – TSH
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Coagulation parameters – PTT, Quick
- If necessary, blood cultures, swabs from drains, etc.
Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification.
| Diabetic ketoacidosis | Hyperosmolar diabetic coma | |
| Glucose | > 250 and < 600 mg/dl (> 13.9 and < 33.3 mmol/l) | > 600 to well over 1,000 mg/dl (> 33.3 to well over 55.5 mmol/l) |
| Ketonuria | +++ | -/+ |
| Arterial pH | < 7,2 | normal |
| Standard bicarbonate | <15 mmol/l | > 15 mmol/l |
| Anion gap | enlarged | normal |
| Plasma osmolality | Increased | strongly increased (> 320 mOsm/l) |
