Bicarbonate Therapy in Severe Diabetic Ketoacidosis

doi:10.1059/0003-4819-105-6-836

Bicarbonate Therapy in Severe Diabetic Ketoacidosis

LAWRENCE R. MORRIS, M.D.;
MARY BETH MURPHY, R.N., M.S.; and
ABBAS E. KITABCHI, Ph.D., M.D.

Memphis, Tennessee

Abstract

Twenty-one adult patients with severe diabetic ketoacidosis entered a randomized prospective protocol in which variable doses of sodium bicarbonate, based on initial arterial pH (6.9 to 7.14), were administered to 10 patients (treatment group) and were withheld from 11 patients (control group). During treatment, there were no significant differences in the rate of decline of glucose or ketone levels or in the rate of increase in pH or bicarbonate levels in the blood or cerebrospinal fluid in either group. Similarly, there were no significant differences in the time required for the plasma glucose level to reach 250 mg/dL, blood pH to reach 7.3, or bicarbonate level to reach 15 meq/L. We conclude that in severe diabetic ketoacidosis (arterial pH 6.9 to 7.14), the administration of bicarbonate does not affect recovery outcome variables as compared with those in a control group.

Article and Author Information

▸From the Division of Endocrinology and Metabolism, Department of Medicine, and the Clinical Research Center, The University of Tennessee, Memphis; Memphis, Tennessee.
Grant support: in part by grant AM-05497 from the National Institutes of Health; grant RR-00211 from the General Clinical Research Center; a research grant from the Juvenile Diabetes Foundation International; and the Abe Goodman Fund for Diabetes Research.
▸Requests for reprints should be addressed to Abbas E. Kitabachi, Ph.D., M.D.; Department of Medicine, The Health Science Center, University of Tennessee, Memphis, 951 Court Avenue, Room 335 M; Memphis, TN 38163.