What is one of the hallmark features of diabetic ketoacidosis?

One of the hallmark features of diabetic ketoacidosis (DKA) is the presence of ketones in urine. DKA typically occurs when there is insufficient insulin in the body, leading to increased lipolysis and the subsequent production of ketone bodies. These ketones accumulate in the blood, causing acidosis, and can also spill over into the urine, which is why their presence is indicative of this condition.

When urine tests show ketones, it signifies that the body is in a state of fat metabolism due to a lack of glucose utilization, which is a direct result of insulin deficiency. This process is a critical pathological feature of DKA, helping to confirm the diagnosis alongside hyperglycemia and metabolic acidosis.

While elevated serum potassium can be seen in DKA due to a shift of potassium from intracellular to extracellular spaces in response to acidosis, it is not a defining hallmark of the condition. Similarly, low blood pressure may be observed, particularly in cases of dehydration, but it is not specific to DKA. Normal blood sugar levels are contrary to DKA, which is characterized by hyperglycemia. Thus, the presence of ketones in urine distinctly signifies the metabolic disturbances associated with diabetic ketoacidosis.