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November 24, 1945


JAMA. 1945;129(13):863-868. doi:10.1001/jama.1945.02860470023006

Although the agents available for the treatment of diabetic acidosis have remained the same for many years, there is today no universally accepted procedure in the management of this common medical emergency. No one will deny that the two most urgently needed substances are insulin and isotonic solution of sodium chloride, but worthy of critical review are (a) the desirability of administering glucose in the early phases of therapy, (b) the need for frequent determinations of blood sugar and carbon dioxide combining power in regulating the treatment, (c) the optimum size of the doses of insulin, and their frequency of administration, and (d) the need for the constant attendance of a team of specialists in the field of diabetes mellitus to guide the therapy.

At the New York Hospital, during the past five years, nearly all patients with diabetic acidosis and diabetic coma have received liberal amounts of glucose by