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Evaluation of the Relationship Between the Change in Base Excess and Clinical Conditions in Patients with Diabetic Ketoacidosis

Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: The aim of this study was to evaluate the post-treatment change in base excess (∆BE) in diabetic ketoacidosis (DKA) and to assess how both the magnitude of correction and the resulting acid-base status relate to presenting severity and routine laboratory parameters. Materials and Methods:We retrospectively analyzed 202 adults presenting with DKA to a tertiary emergency department between 2020 and 2025 who underwent blood gas analysis at presentation and after treatment.∆BE was defined as post-treatment minus baseline base excess.Comparisons were performed using the Mann-Whitney U and Kruskal-Wallis tests, and associations were assessed using Spearman's rho.Results: The median age was 39 years, and 59.9% were male.At presentation, the median pH was 7.08 and HCO₃ was 7.7 mmol/L, indicating marked acidemia.Following treatment, the median ∆BE was 11.9 mmol/L.The magnitude of correction increased with the depth of presenting acidosis (Spearman's rho=-0.75)and was greater in patients with higher baseline white blood cell counts, glucose, urea, creatinine, and C-reactive protein levels and in those admitted to the intensive care unit versus the ward (16.1 vs 7.8 mmol/L, p<0.001).Although ∆BE differed according to presenting severity (p=0.026),post-treatment base excess was statistically similar across severity strata (p=0.374),indicating that treatment brought patients to a comparable acid-base endpoint regardless of the severity at presentation. Conclusion:In DKA, the change in base excess following treatment (∆BE) is a parameter that can be easily derived from laboratory data and is associated with patients' clinical status.
DOI: 10.14744/globecc.2026.71524
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W7204175655
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