FIG. 4.

A: ATP-to-Pi ratios in DKA rats before and after saline and insulin infusion with and without bumetanide. ATP-to-Pi ratios were measured by ³¹P-MRS as described in research design and methods. Bumetanide alone and saline plus insulin with and without bumetanide treatments were started immediately after baseline measurements (0 h). All values are geometric means (95% CI); n = 12, 10, 10, and 12 for no treatment, bumetanide alone, saline and insulin, and saline and insulin with bumetanide treatment groups, respectively. *Within-group comparisons: P < 0.02 for comparison of pre-/posttreatment values in the bumetanide-alone group and the insulin-and-fluid group. Refer to Table 2 for the overall effects of insulin plus saline and bumetanide. Data were analyzed with log-transformed values. B: PCr-to-Pi ratios in DKA rats before and after saline and insulin infusion with and without bumetanide. PCr-to-Pi ratios were measured by ³¹P-MRS as described in research design and methods. Bumetanide alone and saline and insulin with and without bumetanide treatments were started immediately after baseline measurements (0 h). All values are geometric means (95% CI); n = 12, 10, 10, and 12 for no treatment, bumetanide alone, saline and insulin, and saline and insulin with bumetanide treatment groups, respectively. *Within-group comparisons: P = 0.01 for comparison of pre- and posttreatment values in the insulin-and-fluid group. P = 0.051 for comparison of pre- and posttreatment values in the bumetanide-alone group. Refer to Table 2 for the overall effects of insulin plus saline and bumetanide. Data were analyzed with log-transformed values. C: NAA-to-Cr ratios in DKA rats before and after saline and insulin infusion with and without bumetanide. NAA-to-Cr ratios were measured by ¹H-MRS as described in research design and methods. Bumetanide alone and saline and insulin with and without bumetanide treatments started immediately after baseline measurements (0 h). All values are arithmetic means (95% CI); n = 13, 9, 9, and 10 for no treatment, bumetanide alone, saline and insulin, and saline and insulin with bumetanide treatment groups, respectively. *Within-group comparisons: P = 0.03 for comparison of pre- and posttreatment values in the insulin-and-fluid group. Refer to Table 2 for the overall effects of insulin plus saline and bumetanide. D: Intracellular pH in DKA rats before and after saline and insulin infusion with and without bumetanide. Intracellular pH values were determined by ³¹P-MRS as described in research design and methods. Bumetanide alone and saline and insulin with and without bumetanide treatments were started immediately after baseline measurements (0 h). All values are arithmetic means (95% CI); n = 12, 10, 10, and 12 for no treatment, bumetanide alone, saline and insulin, and saline and insulin with bumetanide treatment groups, respectively. *Within-group comparisons: P < 0.05 for comparison of pre- and posttreatment values in the insulin-and-fluid group and the insulin-and-fluid plus bumetanide group. Refer to Table 2 for the overall effects of insulin plus saline and bumetanide.