Which clinical sign is most characteristic of diabetic ketoacidosis?

• A. Kussmaul respiration
• B. Hypertension
• C. Profound edema
• D. Paresthesias

Answer: (A)

In diabetic ketoacidosis the body develops a metabolic acidosis from the buildup of ketone bodies. To compensate, the respiratory system increases both the rate and depth of breathing to blow off carbon dioxide, producing a distinctive pattern known as Kussmaul respiration. This deep, rapid breathing is a hallmark of the acidosis driving the condition, making it the most characteristic sign of DKA.

Other options don’t fit as well because they don’t reflect the acidosis-driven respiratory response. Hypertension is not typical in DKA and dehydration usually leads to low blood pressure. Profound edema isn’t a hallmark feature of DKA, and paresthesias aren’t the classic presenting sign. The presence of Kussmaul respiration helps point to metabolic derangement like DKA rather than the other possibilities.