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Diabetes Care, Vol 3, Issue 4 543-547, Copyright © 1980 by American Diabetes Association

ARTICLES

The value of electrocardiogram monitoring in diabetic ketoacidosis

JI Malone and SJ Brodsky

Electrolyte abnormalities cause fatal cardiac arrhythmias in patients with diabetic ketoacidosis. A patient is reported with electrocardiogram (ECG) abnormalities characteristic of toxic hyperkalemia and hypocalcemia. The ECG abnormalities were noted during the first hour after arriving at the hospital. The laboratory values confirming the electrolyte abnormalities were not available for more than 1 h after the ECG indicated the danger of myocardial toxicity. During the initial 2 h of therapy the patient was urinating and not in shock. ECG monitoring of this patient prevented the routine administration of intravenous potassium, which was potentially lethal. The clinical importance of electrolyte levels in the management of diabetic ketoacidosis is the prevention of cardiac arrhythmias. ECG monitoring should be a minimal standard in the management of diabetic ketoacidosis.
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J. Wolfsdorf, N. Glaser, and M. A. Sperling
Diabetic Ketoacidosis in Infants, Children, and Adolescents: A consensus statement from the American Diabetes Association
Diabetes Care, May 1, 2006; 29(5): 1150 - 1159.
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Copyright © 1980 by the American Diabetes Association.