PMID: 38163Jul 1, 1979

Treatment of severe diabetic ketoacidosis. A comparative study of two methods

Diabetologia
J A LuttermanA van 't Laar

Abstract

Patients with severe diabetic ketoacidosis (pH less than 7.10) were treated according to two protocols. Protocol I consisted of high-dose insulin therapy by intravenous and intramuscular injections and bicarbonate infusion and was used in the first 12 patients; they received an average of 260 U insulin and 167 mmol bicarbonate in the first 6 h of treatment. Protocol II consisted of low-dose continuous intravenous insulin therapy, 8 U/hour, without bicarbonate in a further 12 patients. Rehydration and potassium-supplementation were the same in both methods. Basal data of both groups were not significantly different. The fall of plasma glucose concentration, rise in arterial pH and decrease in 3-hydroxybutyrate were similar in the two groups. The mean time to achieve a pH equal to or greater than 7.30 was 6.8 hours in the high-dose group and 7.6 hours in the low-dose group (p greater than 0.10). Potassium supplementation and potassium concentration during both treatments were the same. During the low-dose treatment the mean (+/- SD) plasma insulin concentration was 121 +/- 46 microU/ml. The presence of insulin binding antibodies did not result in lower free insulin concentrations. Thus, in the treatment of severe ketoacidosis con...Continue Reading

References

Aug 4, 1977·The New England Journal of Medicine·J N FisherA E Kitabchi
Oct 1, 1977·La Nouvelle presse médicale·J MirouzeJ L Selam
Jun 1, 1977·The Journal of Clinical Endocrinology and Metabolism·D S Schade, R P Eaton
Aug 14, 1976·British Medical Journal·N ClumeckE O Balasse
May 1, 1972·Journal of Immunological Methods·F C den HollanderH van Hell
Jun 29, 1974·British Medical Journal·M M PageT E West
Jun 29, 1974·British Medical Journal·W KidsonL Lazarus

Citations

Jan 10, 2001·Endocrinology and Metabolism Clinics of North America·M F DelaneyW M Kettyle
May 16, 2003·Emergency Medicine Journal : EMJ·R D Hardern, N D Quinn
Sep 13, 2011·Annals of Intensive Care·Horng Ruey ChuaRinaldo Bellomo
Nov 19, 2014·TheScientificWorldJournal·María M Adeva-AndanyAlberto Domínguez-Montero
Jan 23, 1998·Annals of Emergency Medicine·S M GreenG J Zimmerman
Jun 6, 2013·The Annals of Pharmacotherapy·Bryson DuhonDarrel W Hughes
Jul 1, 1983·Clinics in Endocrinology and Metabolism·J M Miles, J E Gerich

Related Concepts

Carbonic Acid Ions
Blood
Blood Glucose
Rehydration
Hydrogen-Ion Concentration
Hydroxybutyric Acids
Novolin
Potassium
Diabetic Ketoacidosis

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