What venous pH level is considered a treatment target in DKA?

• A. >7.0
• B. <7.0
• C. >7.3
• D. >7.5

Answer: (C)

In DKA, the treatment goal is to reverse the metabolic acidosis produced by ketoacids through fluids and insulin. A venous pH above 7.3 indicates that the acidosis has substantially resolved and it’s appropriate to progress toward stability with subcutaneous insulin and standard care, rather than pursuing bicarbonate therapy. Bicarbonate is reserved for more severe acidemia, typically when the pH falls below 6.9, so targeting pH above 7.3 avoids unnecessary bicarbonate and aligns with patient safety. A pH higher than 7.5 would imply alkalemia, which isn’t the goal, and a pH below 7.0 remains clearly acidemic and inappropriate as a target. Normal venous pH is roughly 7.35–7.45, so achieving above 7.3 signals sufficient correction to continue with the next steps of management.