The Use of Alkali Therapy in Severe Diabetic Ketoacidosis
- Kashif A. Latif, MD1,
- Amado X. Freire, MD2,
- Abbas E. Kitabchi, PHD, MD1,
- Guillermo E. Umpierrez, MD1 and
- Nauman Qureshi, MD1
- 1Division of Endocrinology, Department of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee
- 2Division of Pulmonary and Critical Care, Department of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee
The use of bicarbonate in patients with diabetic ketoacidosis (DKA) is controversial (1), especially in patients with severe DKA (pH <7.0). Previous studies have shown that the use of bicarbonate in patients with moderate DKA (pH >7.0) is not associated with better outcomes, when compared with saline-treated control subjects (2–5), and can generate lactate (3). The use of bicarbonate therapy in patients with severe DKA has not been addressed adequately, due to a lack of data on benefit or harm of bicarbonate therapy in severe DKA, but dogmatic use of bicarbonate …
