Diabetic ketoacidosis
diseaseOn this page
Also known as KPD
Summary
Diabetic ketoacidosis (MONDO:0012819) is a disease with 46 GWAS associations across 13 studies and 53 clinical trials. Top therapeutic interventions include insulin glargine, arginine hydrochloride, and lactic acid. A subtype of diabetes mellitus — broader associated-gene and molecular evidence is on the parent page (see Disease family below).
At a glance
- GWAS associations: 46
- Clinical trials: 53
Clinical features
No curated clinical features (Orphanet) for this disease.
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | diabetic ketoacidosis |
| Mondo ID | MONDO:0012819 |
| EFO | EFO:1000897 |
| MeSH | D016883 |
| DOID | DOID:1837 |
| SNOMED CT | 420422005 |
| UMLS | C0011880 |
| MedGen | 8351 |
| MedDRA | 10012671 |
| Is cancer (heuristic) | no |
Also known as: KPD
Data availability: 46 GWAS associations (13 studies).
Disease family
This is a subtype of diabetes mellitus. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.
Classification path: disease › human disease › disease by body system or component › digestive system disorder › pancreas disorder › endocrine pancreas disorder › diabetes mellitus › diabetic ketoacidosis
Related subtypes (7): type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes, maternally-inherited diabetes and deafness, monogenic diabetes, type 5 diabetes mellitus, cystic fibrosis-related diabetes
Genetics & variants
GWAS landscape
46 GWAS associations across 13 studies. Top hits map to 23 distinct genes (as reported by GWAS).
Top associations by p-value
| rsID | p-value | Gene | Risk allele | Odds ratio |
|---|---|---|---|---|
| rs9273363 | 2e-64 | HLA-DQA1 - HLA-DQB1 | C | 0.96 |
| rs9273508 | 2e-33 | HLA-DQB1, HLA-DQB1-AS1 | ? | |
| rs186568031 | 1e-25 | SLC16A11 - CLEC10A | C | 0.59 |
| rs539981616 | 2e-21 | HLA-DQA1 - HLA-DQB1 | C | 0.58 |
| rs5400 | 2e-19 | SLC2A2 | G | 0.32 |
| rs6679677 | 6e-15 | PHTF1 - RSBN1 | C | 0.62 |
| rs1794269 | 8e-15 | HLA-DQB1 - MTCO3P1 | ? | 2.67 |
| chr11:2184848 | 1e-14 | G | 0.63 | |
| rs141499620 | 1e-14 | ANKRD42 | G | 3.11 |
| rs181291048 | 4e-14 | SHISA9 - TMF1P1 | G | 4.27 |
| rs139686691 | 4e-14 | RNU6-533P - RPL23P10 | T | 3.71 |
| rs557788509 | 6e-14 | ZFPM2 | G | 3.96 |
| rs561726636 | 6e-14 | PBX1 | G | 3.61 |
| rs542926685 | 1e-13 | SEZ6L | G | 2.97 |
| rs185905894 | 2e-13 | MIR646HG - LINC01718 | C | 4.26 |
| rs530408688 | 4e-13 | BTG3 | A | 3.16 |
| rs11575055 | 4e-13 | IL13, TH2LCRR | C | 3.05 |
| rs555167471 | 6e-13 | TNKS2 - FGFBP3 | A | 3.98 |
| rs183910463 | 8e-13 | RFLNA | G | 4.22 |
| rs191563060 | 1e-12 | SCNN1B | G | 3.06 |
| rs538810025 | 1e-12 | B3GALT1 | C | 3.64 |
| rs3842752 | 5e-12 | INS-IGF2, INS | G | 0.57 |
| rs183360430 | 5e-12 | PENK-AS1, LINC00968 | T | 2.51 |
| rs573330662 | 6e-12 | CNTN5 - RN7SL222P | C | 3.74 |
| rs550539923 | 6e-12 | LINC03142 - SUMO2P2 | G | 3.26 |
| rs372193800 | 7e-12 | CECR2 | C | 4.28 |
| rs535195863 | 9e-12 | ZNF283 | G | 2.04 |
| rs551592540 | 9e-12 | RNA5SP94 - MIR4432HG | G | 2.9 |
| rs564787815 | 1e-11 | ZNF734P - SEPTIN7P5 | C | 2.31 |
| rs190791251 | 2e-11 | AK2P2 - MEMO1 | C | 3.44 |
Top studies (by case count)
| Study | Lead author | Year | Cases | Controls | Title |
|---|---|---|---|---|---|
| GCST90477315 | Verma A | 2024 | 1,202 | 448,916 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90475668 | Verma A | 2024 | 893 | 120,189 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90479880 | Verma A | 2024 | 893 | 120,189 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90651283 | Liu TY | 2025 | 656 | 196,787 | Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population. |
| GCST90475662 | Verma A | 2024 | 530 | 450,407 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90476481 | Verma A | 2024 | 269 | 59,377 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90435702 | Zhou W | 2018 | 237 | 388,756 | Efficiently controlling for case-control imbalance and sample relatedness in large-scale genetic association studies. |
| GCST90043633 | Jiang L | 2021 | 228 | 456,120 | A generalized linear mixed model association tool for biobank-scale data. |
| GCST90476480 | Verma A | 2024 | 215 | 121,380 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90479875 | Verma A | 2024 | 215 | 121,380 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
Variant details and genetic-evidence tiers
Tier distribution (top 50 variants)
| Tier | Variants |
|---|---|
| Tier 1: coding | 1 |
| Tier 2: splice/UTR | 2 |
| Tier 3: regulatory | 1 |
| Tier 4: intronic/intergenic | 37 |
MAF distribution
| Bucket | Variants |
|---|---|
| common (>=0.05) | 9 |
| low_freq (0.01-0.05) | 1 |
| rare (<0.01) | 31 |
| unknown | 0 |
Functional consequences
| Consequence | Count |
|---|---|
| intergenic_variant | 18 |
| intron_variant | 17 |
| 3_prime_UTR_variant | 2 |
| non_coding_transcript_exon_variant | 1 |
| missense_variant | 1 |
| unknown | 1 |
| regulatory_region_variant | 1 |
Top variants
| rsID | Chr | Pos | Alleles | MAF | Consequence | Gene | p-value | Tier |
|---|---|---|---|---|---|---|---|---|
| rs9273363 | 6 | 32658495 | C>A,G | 0.242 | intergenic_variant | HLA-DQA1 - HLA-DQB1 | 2e-64 | Tier 4: intronic/intergenic |
| rs9273508 | 6 | 32660662 | G>A | 0.05 | non_coding_transcript_exon_variant | HLA-DQB1, HLA-DQB1-AS1 | 2e-33 | Tier 4: intronic/intergenic |
| rs186568031 | 17 | 7050462 | C>T | 0.04 | intergenic_variant | SLC16A11 - CLEC10A | 1e-25 | Tier 4: intronic/intergenic |
| rs539981616 | 6 | 32651394 | C>G | 0.238 | intergenic_variant | HLA-DQA1 - HLA-DQB1 | 2e-21 | Tier 4: intronic/intergenic |
| rs5400 | 3 | 171014511 | G>A,C,T | 0.199 | missense_variant | SLC2A2 | 2e-19 | Tier 1: coding |
| rs6679677 | 1 | 113761186 | C>A,T | 0.079 | intergenic_variant | PHTF1 - RSBN1 | 6e-15 | Tier 4: intronic/intergenic |
| rs1794269 | 6 | 32706117 | C>G,T | 0.05 | intergenic_variant | HLA-DQB1 - MTCO3P1 | 8e-15 | Tier 4: intronic/intergenic |
| chr11:2184848 | 0.317 | 1e-14 | Tier 4: intronic/intergenic | |||||
| rs141499620 | 11 | 83238964 | G>A | 0.001 | intron_variant | ANKRD42 | 1e-14 | Tier 4: intronic/intergenic |
| rs181291048 | 16 | 13409044 | G>A | 0.001 | intron_variant | SHISA9 - TMF1P1 | 4e-14 | Tier 4: intronic/intergenic |
| rs139686691 | 8 | 36523513 | T>C | 0 | intron_variant | RNU6-533P - RPL23P10 | 4e-14 | Tier 4: intronic/intergenic |
| rs557788509 | 8 | 105124874 | G>A | 0 | intergenic_variant | ZFPM2 | 6e-14 | Tier 4: intronic/intergenic |
| rs561726636 | 1 | 164648017 | G>A,T | 0.001 | intron_variant | PBX1 | 6e-14 | Tier 4: intronic/intergenic |
| rs542926685 | 22 | 26382120 | G>A,C,T | 0.001 | 3_prime_UTR_variant | SEZ6L | 1e-13 | Tier 2: splice/UTR |
| rs185905894 | 20 | 60990564 | C>T | 0.001 | intergenic_variant | MIR646HG - LINC01718 | 2e-13 | Tier 4: intronic/intergenic |
| rs530408688 | 21 | 17603903 | A>C | 0.001 | intron_variant | BTG3 | 4e-13 | Tier 4: intronic/intergenic |
| rs11575055 | 5 | 132657213 | C>T | 0.001 | intergenic_variant | IL13, TH2LCRR | 4e-13 | Tier 4: intronic/intergenic |
| rs555167471 | 10 | 91894078 | A>G | 0.001 | intergenic_variant | TNKS2 - FGFBP3 | 6e-13 | Tier 4: intronic/intergenic |
| rs183910463 | 12 | 124192220 | G>A | 0 | intergenic_variant | RFLNA | 8e-13 | Tier 4: intronic/intergenic |
| rs191563060 | 16 | 23310329 | G>A | 0.001 | intron_variant | SCNN1B | 1e-12 | Tier 4: intronic/intergenic |
| rs538810025 | 2 | 167499470 | C>T | 0 | intron_variant | B3GALT1 | 1e-12 | Tier 4: intronic/intergenic |
| rs3842752 | 11 | 2159843 | G>A | 0.191 | 3_prime_UTR_variant | INS-IGF2, INS | 5e-12 | Tier 2: splice/UTR |
| rs183360430 | 8 | 56529823 | T>C | 0.001 | intron_variant | PENK-AS1, LINC00968 | 5e-12 | Tier 4: intronic/intergenic |
| rs573330662 | 11 | 100461671 | C>A,T | 0 | intergenic_variant | CNTN5 - RN7SL222P | 6e-12 | Tier 4: intronic/intergenic |
| rs550539923 | 9 | 23622167 | G>A | 0.001 | intron_variant | LINC03142 - SUMO2P2 | 6e-12 | Tier 4: intronic/intergenic |
| rs372193800 | 22 | 17453827 | C>T | 0 | intron_variant | CECR2 | 7e-12 | Tier 4: intronic/intergenic |
| rs535195863 | 19 | 43832932 | G>A,T | 0.002 | intron_variant | ZNF283 | 9e-12 | Tier 4: intronic/intergenic |
| rs551592540 | 2 | 60208564 | G>A,C,T | 0.001 | intergenic_variant | RNA5SP94 - MIR4432HG | 9e-12 | Tier 4: intronic/intergenic |
| rs564787815 | 7 | 63467485 | C>A | 0.001 | intergenic_variant | ZNF734P - SEPTIN7P5 | 1e-11 | Tier 4: intronic/intergenic |
| rs190791251 | 2 | 31837352 | C>A | 0.001 | regulatory_region_variant | AK2P2 - MEMO1 | 2e-11 | Tier 3: regulatory |
Genes & proteins
No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).
Function
No pathway enrichment — requires an associated-gene cohort.
Therapeutics
Drugs indicated for this disease
0 approved, 1 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.
| Drug | Development status |
|---|---|
| Sodium Chloride | Phase 3 (in late-stage trials) |
Clinical trials & evidence
Clinical trials
Clinical trials: 53.
Phase distribution (across all retrieved trials)
| Phase | Trials |
|---|---|
| Not specified | 42 |
| PHASE4 | 4 |
| PHASE3 | 2 |
| PHASE2 | 2 |
| PHASE2/PHASE3 | 1 |
| PHASE1/PHASE2 | 1 |
| PHASE1 | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT00590044 | PHASE4 | COMPLETED | Basal Insulin in the Management of Patients With Diabetic Ketoacidosis (DKA) |
| NCT03066440 | PHASE4 | TERMINATED | Double Blinded Randomized Control Trial of Types of IVF in Children With DKA |
| NCT03107208 | PHASE4 | COMPLETED | Early Glargine (Lantus) in DKA Management in Children With Type 1 Diabetes |
| NCT04567225 | PHASE4 | TERMINATED | Early Basal Insulin Administration in Adult Diabetic Ketoacidosis Management |
| NCT05752279 | PHASE3 | RECRUITING | Balanced Multi-Electrolyte Solution Versus Saline Trial for Diabetic KetoAcidosis |
| NCT06955416 | PHASE2/PHASE3 | RECRUITING | REAMBERIN® 1.5% in Rehydration Therapy of Diabetic Ketoacidosis |
| NCT01365793 | PHASE3 | COMPLETED | Randomized Control Trial of Fluid Therapy for Pediatric Diabetic Ketoacidosis |
| NCT07167693 | PHASE1/PHASE2 | RECRUITING | Phase 1 Trial of Arginine Hydrochloride for the Management of Diabetic Ketoacidosis in Type 2 Diabetes |
| NCT03717896 | PHASE2 | COMPLETED | Thiamine As Adjunctive Therapy for Diabetic Ketoacidosis |
| NCT05155917 | PHASE2 | UNKNOWN | Concurrent Subcutaneous Basal Insulin and Intravenous Insulin Pump in Hyperglycemic Crisis Patients Under Critical Care |
| NCT04234867 | PHASE1 | TERMINATED | Study to Explore the Effect of Dapagliflozin and Stress in Adolescent and Adult Subjects With Type 1 Diabetes (T1D) |
| NCT06186245 | Not specified | ENROLLING_BY_INVITATION | Starvation in the Treatment of Diabetic Ketoacidosis |
| NCT06599203 | Not specified | NOT_YET_RECRUITING | Children with Diabetic Ketoacidosis |
| NCT06748365 | Not specified | RECRUITING | Serum Ferritin and Prognosis of DKA |
| NCT07127406 | Not specified | ACTIVE_NOT_RECRUITING | Postoperative Euglycemic Ketoacidosis Frequency in Sodium-Glucose Cotransporter-2 Inhibitor Users |
| NCT07193069 | Not specified | RECRUITING | Clinical and Biological Signs of Dapagliflozin Overdose in ICU Patients With Metformin Poisoning |
| NCT07483879 | Not specified | RECRUITING | Biomarkers of Acute Organ Injury in Pediatric Newly Diagnosed Type 1 Diabetes |
| NCT00179127 | Not specified | COMPLETED | Use of Insulin Glargine to Treat Diabetic Ketoacidosis |
| NCT00426413 | Not specified | COMPLETED | Ketosis Prone Diabetes in African-Americans |
| NCT00589680 | Not specified | COMPLETED | Compliance With American Diabetes Association Treatment Guidelines for Adult Ketoacidosis |
| NCT00629707 | Not specified | COMPLETED | Cerebral Edema in Pediatric Diabetic Ketoacidosis |
| NCT00920725 | Not specified | COMPLETED | Subcutaneous Aspart Insulin to Treat Diabetic Ketoacidosis (DKA) and Beta-Hydroxybutyrate Testing in DKA |
| NCT01753921 | Not specified | COMPLETED | Evaluation of a Non-invasive Brain Compliance Measurement Device |
| NCT02006342 | Not specified | COMPLETED | Effectiveness of Subcutaneous Glargine On The Time To Closure of The Anion Gap in Patients Presenting to the Emergency Department With Diabetic Keto-acidosis |
| NCT02130180 | Not specified | UNKNOWN | DKA Optic Ultrasound |
| NCT02443415 | Not specified | COMPLETED | Diabetic Ketoacidosis: Brain Morphology and Cognition |
| NCT02548494 | Not specified | TERMINATED | Early Administration of Long-acting Insulin Treatment of Diabetic Ketoacidosis in Pediatric Type 1 Diabetes |
| NCT02930044 | Not specified | COMPLETED | Early Subcutaneous Insulin Glargine Plus Standard of Care for Treatment of Diabetic Ketoacidosis |
| NCT02950181 | Not specified | TERMINATED | Descriptive Analysis of Near Infrared Spectroscopy in Critically Ill and Injured Pediatric and Neonatal Patients |
| NCT03128229 | Not specified | COMPLETED | Diabetic Kidney Alarm (DKA) Study |
| NCT03182569 | Not specified | COMPLETED | Flexible Catheter for Insulin in Diabetes |
| NCT03660189 | Not specified | TERMINATED | Two Bag System for Diabetic Ketoacidosis |
| NCT04017221 | Not specified | COMPLETED | Safety of Sodium-glucose Cotransporter 2 (SGLT2) Inhibitors Among Patients With Type 2 Diabetes |
| NCT04656236 | Not specified | COMPLETED | Metabolic Effects of Exogenous 3-hydroxybutyrate in Patients With Type 1 Diabetes and Healthy Controls |
| NCT04819178 | Not specified | WITHDRAWN | Real Life Evaluation of SGLT2 Use in Type 1 Diabetes |
| NCT04825639 | Not specified | COMPLETED | Identifying Risk Factors for Developing AKI in Sepsis |
| NCT04926740 | Not specified | COMPLETED | Intravenous Fluids in Adults With Diabetic Ketoacidosis in the Emergency Department |
| NCT04940897 | Not specified | COMPLETED | Use of Blood Ketone Meters to Improve Ambulance Hyperglycaemia Care |
| NCT04977011 | Not specified | COMPLETED | Effectiveness of Music Intervention on Anxiety and Physiological Responses in Critical Ill Patient |
| NCT05383404 | Not specified | UNKNOWN | Clinical and Laboratory Parameters Associated With Different Degrees of Dehydration Among Children With Diabetic Ketoacidosis |
Drugs tested across these trials (top 30)
| Molecule | Max phase | Trials referencing |
|---|---|---|
| INSULIN GLARGINE | 4 | 7 |
| ARGININE HYDROCHLORIDE | 4 | 1 |
| LACTIC ACID | 4 | 1 |
| D-LACTIC ACID | 3 | 1 |
Related Atlas pages
- Drugs: Insulin Glargine, Arginine, Lactic Acid, D-Lactic Acid