Abstract
Of a series of 211 episodes of diabetic metabolic decompensation 37 had severe euglycaemic ketoacidosis (a blood sugar level of less than 300 mg/100 ml and a plasma bicarbonate of 10 mEq/1. or less). All were young insulin-dependent diabetics, only one being previously undiagnosed. Vomiting was a common factor, and in all carbohydrate reduction occurred with continued or increased daily insulin dose. Treatment comprised fluid and electrolyte replacement and large doses of insulin covered by adequate carbohydrate, many receiving 10% dextrose. Alkali was either withheld or given sparingly and the therapy was monitored by serial estimations of plasma bicarbonate. All the patients survived.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ADDIS G. J., THOMSON W. S., WELCH J. D. BICARBONATE THERAPY IN DIABETIC ACIDOSIS. Lancet. 1964 Aug 1;2(7353):223–225. doi: 10.1016/s0140-6736(64)90180-1. [DOI] [PubMed] [Google Scholar]
- Gerich J. E., Martin M. M., Recant L. Clinical and metabolic characteristics of hyperosmolar nonketotic coma. Diabetes. 1971 Apr;20(4):228–238. doi: 10.2337/diab.20.4.228. [DOI] [PubMed] [Google Scholar]
- Posner J. B., Plum F. Spinal-fluid pH and neurologic symptoms in systemic acidosis. N Engl J Med. 1967 Sep 21;277(12):605–613. doi: 10.1056/NEJM196709212771201. [DOI] [PubMed] [Google Scholar]
- Zimmet P. Z., Taft P., Ennis G. C., Sheath J. Acid production in diabetic acidosis; a more rational approach to alkali replacement. Br Med J. 1970 Sep 12;3(5723):610–612. doi: 10.1136/bmj.3.5723.610. [DOI] [PMC free article] [PubMed] [Google Scholar]