Metabolic Studies in Severe Diabetic Ketosis

Abstract

given intravenously over three to six hours. As soon as the blood-sugar and plasma-potassium levels began to fall, this was replaced by a 5 per cent, glucose solution containing Na 30 mEq, K 20 mEq, CI 24 mEq, lactate 20 mEq, and phosphate 6 mEq per litre, two to four litres being given over 12 to 24 hours. This solution, in view of its potassium content, was not given faster than one litre in four hours. Oral feeding was commenced with the first of a series of three simple post-coma diets. These were specially prepared by the same dietician, and repeated analyses of duplicate diets were made throughout the study. Forty-eight complete diets were analysed (Table Supplements of milk and fruit juice were allowed in some cases; these were also analysed. The patients F. H. and J. R. were given additional potassium phosphate by mouth, and G. R. additional potassium chloride. All urine, faeces, vomit, and rejected food was collected for 12-or 24-hour periods and analysed as described below. Detailed figures of intake, output, and balance are given in the Appendix (Table The balance studies lasted from eight to twelve days.