DIABETIC ACIDOSIS: AN EVALUATION OF THE CAUSE, COURSE AND THERAPY OF 73 CASES*

doi:10.1059/0003-4819-52-1-55

DIABETIC ACIDOSIS: AN EVALUATION OF THE CAUSE, COURSE AND THERAPY OF 73 CASES*

ALAN S. COHEN, M.D.
Boston, Massachusetts
;
VERNON K. VANCE, M.D.
Beckley, West Virginia
;
JOHN W. RUNYAN, JR., M.D., F.A.C.P.
Albany, New York
; and
DAVID HURWITZ, M.D.
Boston, Massachusetts

Requests for reprints should be addressed to Alan S. Cohen, M.D., Department of Medicine, Arthritis Unit, Massachusetts General Hospital,
Boston 14, Massachusetts
.

Excerpt

INTRODUCTION Diabetic acidosis until recently ranked high among the causes of death in any series of diabetic patients. The fall in mortality in the last few years has been clearly documented by Root.¹ However, the case fatality rate in this complication of diabetes mellitus is still quite significant, and in a relatively recent publication has been noted to vary from 2.4% to 43.7% at a group of large general hospitals.²

Among the many factors contributing to the lowering of mortality are the early and adequate use of insulin, the advent of antibiotic therapy for associated and complicating infections, and the

Summario in Interlingua

Esseva revistate in detalio le etiologia, le curso, e le tractamento de acidosis diabetic in 73 patientes admittite a un hospital municipal. Esseva constatate que disturbationes emotional si ben como infectiones esseva causas precipitatori del acidosis. Non un sol del gruppo de cognoscitemente diabetic patientes habeva dominio del morbo. Le aspecto clinic del acidosis in le casos del presente serie esseva usualmente non-complicate, excepte le presentia de acute dolores abdominal in plures del patientes. Le dolores dispareva completemente intra 12 horas post le initiation de un forma adequate de tractamento.

Quanto al tractamento del diabete, le uso precoce de large doses de insulina pareva exercer un effecto benefic. Como reimplaciamento de liquido esseva usate initialmente un solution hypotonic continente natrium, 100 mEq/L, chloruro, 60 mEq/L, e lactato, 40 mEq/L. Le precoce introduction de insulina a action prolongate e de ambulation resultava in un reduction del periodo de hospitalisation. Le periculo de continue catheterisationes e le importantia del uso de antibioticos pro infectiones specific es discutite. Le series includeva quatro casos mortal, un mortalitate de 5.5%. Omne iste mortes occurreva in patientes de plus que 65 annos de etate qui omnes habeva altere complicationes.

Article and Author Information

↵* Received for publication March 7, 1959.
From the Thorndike Memorial Laboratory and the Second and Fourth (Harvard) Medical Services, Boston City Hospital, the Department of Medicine, Harvard Medical School, and the Diabetes Service, Boston City Hospital. These studies were aided by USPHS Training Grant #2A-5060.