Specific testing for beta-hydroxybutyrate can be performed by many laboratories. Look for glycosuria and urine ketosis. If the osmolality is less than this in a comatose patient, search for another cause of obtundation. Hyperamylasemia may be seen even in the absence of pancreatitis. BUN is increased.
Anion gap is higher than normal.
Repeat labs are critical. Potassium needs to be checked every 1-2 hours during initial treatment. Glucose and other electrolytes should be checked every 2 hours or so during initial aggressive volume, glucose, and electrolyte management. If the initial phosphorous was low, it should be monitored every 4 hours during therapy. Rule out pulmonary infection.