This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (62)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

K. George M. M. Alberti, MA, DPhil, BM, BCh, MRCPath, MRCP

Arch Intern Med. 1977;137(10):1367-1376.

Abstract
Severe diabetic ketoacidosis remains a lethal condition. Many deaths occur during therapy and are avoidable. Treatment includes rehydration, administration of insulin and potassium, and clinical care. For many years very large doses of insulin were used. Recently, it has been suggested that such large doses are unnecessary and lead to undue hypokalemia, hypoglycemia, and osmotic disequilibria. Many studies are now available that show that low doses of insulin given as continuous intravenous infusions (4 to 10 units/hr) or as hourly intramuscular injections (20 units initially, then 5 units/ hr) are as effective as large doses in treating severe ketoacidosis. The new regimens are simple to use, predictable, and safe. Potassium shifts are less than with large insulin doses and insulin resistance has been shown to be a relatively minor problem. The new regimens are particularly suitable for use in nonspecialist centers.

(Arch Intern Med 137:1367-1376, 1977)

Author Affiliations
From the Department of Chemical Pathology and Human Metabolism, General Hospital, Southampton, England.

Footnotes
Reprint requests to General Hospital, Southampton S09 4XY, England (Dr Alberti).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Recent advances in the monitoring and management of diabetic ketoacidosis
Wallace and Matthews
QJM 2004;97:773-780.
ABSTRACT | FULL TEXT  

Treatment of Diabetic Ketoacidosis With Subcutaneous Insulin Aspart
Umpierrez et al.
Diabetes Care 2004;27:1873-1878.
ABSTRACT | FULL TEXT  

Management of Diabetes and Hyperglycemia in Hospitals
Clement et al.
Diabetes Care 2004;27:553-591.
FULL TEXT  

Frequent Hypoglycemic Episodes in the Treatment of Patients With Diabetic Ketoacidosis
Malone et al.
Arch Intern Med 1992;152:2472-2477.
ABSTRACT  

Bicarbonate Therapy in Severe Diabetic Ketoacidosis
MORRIS et al.
ANN INTERN MED 1986;105:836-840.
ABSTRACT  

Treatment of Diabetic Ketoacidosis
Levine and Loewenstein
Arch Intern Med 1981;141:713-715.
ABSTRACT  

Low-Dose Continuous Intravenous Insulin Infusion in Childhood Diabetic Ketoacidosis
Perkin and Marks
CLIN PEDIATR 1979;18:540-548.
ABSTRACT  

Similar Responsiveness of Diabetic Ketoacidosis to Low-Dose Insulin by Intramuscular Injection and Albumin-Free Infusion
SACKS et al.
ANN INTERN MED 1979;90:36-42.
ABSTRACT  

Diabetic Ketoacidosis: New Concepts and Trends in Pathogenesis and Treatment
KREISBERG
ANN INTERN MED 1978;88:681-695.
ABSTRACT  

Diabetic Ketoacidosis
Kumar et al.
Arch Intern Med 1978;138:660-660.
ABSTRACT