Investigations

Take a urine sample and test for

• ketones ^c
• leukocytes or nitrites - if abnormal send for culture ^d

No ketones on urine dipstick make diabetic ketoacidosis very unlikely

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
suspected diabetic ketoacidosis c (pre-test probability: 14%)	diabetic ketoacidosis (elevated glucose, metabolic acidosis and ketonaemia)	positive urine ketone dipstick	3.2 (2.9 to 3.7)	35%	0.015 (0.0021 to 0.10)	0.24%