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Medline ® Abstract for Reference 22 of ‘Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults:

This sort of reaction is known as an acid-base neutralization reaction. Common clinical findings were lethargy, anorexia, polyuria, polydipsia, and weight loss. The one group was hyponatremia with hyperkalemia in 17 patients in diabetic ketoacidosis (132.9 +/- 2.0 and 5.7 +/- 0.2 mEq/l), and 4 patients in non-ketotic hyperosmolar coma (125.8 +/- 4.3 and 5.2 +/- 0.5 mEq/l). The purpose of this study was to assess the accuracy of VBG electrolytes for diagnosing DKA using serum chemistry electrolytes measures as the criterion standard and to describe the correlation between VBG and serum chemistry electrolytes in a sample of hyperglycemic patients seen in the emergency department (ED). The mean (±SD) arterial pH was 7.07±0.20, and only three patients had severe acidemia. In practice a long time interval between correction of the hyperglycaemia and correction of the acidosis may be a problem when the continuous infusion of insulin is used. What is the “safe level” of plasmatic insulin concentration that makes development of DKA impossible?

In 38 patients (62.9%), QTUc was more than or equal to 450 milliseconds. Glucagon promotes the formation of glucose (via glycogenolysis and gluconeogenesis), lipolysis, and formation of ketone bodies. Insulin administration brings about correction of DKA and return of serum [K] concentration to the normal range in the majority of the hyperglycemic episodes without the need for other measures. The tall T waves that are characteristic of hyperacute ischemic changes tend to be associated with a long QT interval, and the T waves are broad rather than narrow and pointed.

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