Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications

<i>Background and Objectives</i>: Diabetic ketoacidosis (DKA) represents the most prevalent hyperglycemic emergency and poses a significant life-threatening metabolic risk for individuals with diabetes. The present study examines the predictive role of the leukocyte glucose index (LGI) values at baseline in diagnosing the severity of DKA and their correlation with the presence of diabetes-related microvascular complications. <i>Materials and Methods</i>: A retrospective observational study was conducted involving a total of 94 patients who had previously confirmed diagnoses of either Type I or Type II diabetes mellitus and presented with ketoacidosis upon emergency admission to the Department of Diabetology, Nutrition, and Metabolic Disease. Demographic information, values of arterial systolic and diastolic pressure, known duration and type of diabetes, severity of ketoacidosis, routine laboratory results, and blood gas analyses were retrieved from the hospital's electronic database. <i>Results</i>: Higher diastolic blood pressure (DBP) values were observed in both mild (<i>p</i> = 0.021) and severe DKA (<i>p</i> = 0.035) compared to moderate DKA. When examining laboratory data, elevated white blood cell (WBC) counts were observed in severe DKA when compared to mild DKA (<i>p</i> = 0.009), as well as increased neutrophil counts in both moderate (<i>p</i> = 0.038) and severe (<i>p</i> = 0.011) DKA relative to mild DKA. Furthermore, patients with severe DKA exhibited lower values of venous blood pH, partial pressure of carbon dioxide (pvCO₂), base excess (BE), and bicarbonate than the other groups (all <i>p</i> < 0.05), alongside higher levels of lactate, anion gap, and LGI (all <i>p</i> < 0.05). Regarding the parameters of arterial blood gas, we identified a negative correlation between LGI values and venous blood pH (r = -0.383, <i>p</i> < 0.001), serum bicarbonate (r = -0.352, <i>p</i> < 0.001), pCO₂ (r = -0.271, <i>p</i> = 0.009), and BE (r = -0.330, <i>p</i> < 0.001). At univariate analysis, elevated LGI values are associated with the severity of DKA (OR: 1.87, <i>p</i> = 0.016) and diabetes-related microvascular complications (OR: 2.16, <i>p</i> = 0.010). <i>Conclusions</i>: The positive correlation between LGI and DKA severity and between LGI and diabetes microvascular complications highlights the potential utility of LGI as a predictive marker, facilitating early risk stratification and clinical decision-making.