Soner YEŞİLYURT, Mehmet TAYFUR
Global Emergency and Critical Care - 2026;5(3):178-185
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 HCO? 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.
