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Article
January 1961

Hydrogen Ion Metabolism in Diabetic AcidosisDisturbances Before and After Treatment

Arch Intern Med. 1961;107(1):63-68. doi:10.1001/archinte.1961.03620010067011
Abstract

The basic disturbances of diabetic acidosis and its treatment are the same at all ages. To be sure, fluid and electrolyte deficits tend to develop more rapidly and progress further in children. Fortunately, young patients possess greater reserve of cardiac, pulmonary, and renal function than is found in the diabetic patients who enter our medical wards in coma. All too frequently our patients combine diabetic acidosis with severe crippling complications such as senility, advanced arteriosclerosis, pancreatitis, renal papillary necrosis, and alcoholism. It is the frequency of complicated cases which determines the survival rate in the better clinics.

I will not review the practical aspects of insulin, fluid, electrolyte, and carbohydrate therapy. Give or take 10 or 15 mEq/liter, there is increasing agreement among the students of the disease. The need for initial rapid restoration of extracellular fluid volume followed by sustaining fluids which are hypotonic, to provide needed water, and

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