Diagnosis is generally based on symptoms. An elevated anion gap metabolic acidosis and ketosis is the classic present. However, a mixed acid-base disorder may be present especially if vomiting is contributing to a hypochloremic alkalosis. The ketone which is present is mostly beta-hydroxybutyrate rather than acetoacetate resulting in only a weakly positive nitroprusside test. People usually do not present with high blood sugar or sugar in the urine. This can cause false negative results when testing urine ketones as they only measure acetoacetate. Ethanol level are often low or negative despite a chronic alcohol use history. Electrolyte disturbances may include hypokalemia or hypomagnesemia may also be present. Differential diagnosis Other conditions that may present similarly include other causes of high anion gap metabolic acidosis such as diabetic ketoacidosis, toxic alcohol ingestion, and starvation ketosis. Toxic alcohol ingestion include methanol and ethylene glycol poisoning. Pancreatitis,<unk>  hepatitis, and gastritis may also result in similar symptoms. The ratio of beta-hydroxybutryate to acetoacetate is usually higher in<unk>  (8:1) in contrast to diabetic ketoacidosis (3:1).
Alcoholic ketoacidosis
Diabetic ketoacidosis
Serkal syndrome
Flint water crisis
Hypovolemic shock
Diabetic coma
Septic shock
Hyperosmolar syndrome