The value of continuous ECG monitoring during treatment of diabetic ketoacidosis. A computer study.

In order to confirm or refute the previously held view that electrocardiographic (ECG) abnormalities are frequent in diabetic ketoacidosis, we have undertaken continuous ECG monitoring for 24 h, with subsequent computer analysis, in 14 diabetic patients admitted with severe ketoacidosis. There was a steady fall in heart rate during the 24-h except in 3 severely dehydrated patients. Depression of the ST-segment was minimal and ST-segment height correlated significantly with heart rate, whereas no consistent relationship was found between T-wave amplitude and either heart rate or plasma potassium. Two patients developed short periods of supraventricular ectopic beats. Although ECG monitoring has been claimed to be a useful aid in the management of diabetic ketoacidosis, this study clearly demonstrates that significant ECG changes are rare and ECG monitoring thereafter adds little to careful clinical observation and regular biochemical assessment.