New trends in the management of diabetic ketoacidosis

The diagnosis of ketoacidosis can be rapidly confirmed by simple determinations of blood glucose, serum ketones and arterial pH. The initial hydrating fluid is isotonic saline, followed by half-normal saline with buffered potassium phosphate. As soon as the blood glucose drops below 300 mg. percent, 5% glucose is added to the infusion. Following an initial regular insulin dose of 20 u. intramuscularly or 10 u. intravenously, subsequent doses of 10 u. every hour are given either by intravenous drip or by injection deep into the deltoid muscle.