Fisher J N
Compr Ther. 1979 Apr;5(4):43-8.
Many aspects of DKA treatment have become dogma without benefit of critical randomized prospective studies. Although recommendations for low-dose insulin therapy have passed the test of working in practice, many facets of treatment such as bicarbonate vs. no bicarbonate, phosphate replenishment, the merits of rapid vs. slow correction of hyperglycemia and acidosis need to be prospectively studied. In the final analysis, while insulin, fluid, and electrolyte administration are all important in the treatment of DKA, success most often hinges on careful hour-by-hour monitoring of the patient by a concerned and knowledgeable physician.
糖尿病酮症酸中毒（DKA）治疗的许多方面已成为教条，却未得益于严格的随机前瞻性研究。尽管小剂量胰岛素治疗的建议已通过实践检验，但治疗的许多方面，如使用碳酸氢盐与不使用碳酸氢盐、补充磷酸盐、快速与缓慢纠正高血糖和酸中毒的优缺点等，仍需进行前瞻性研究。归根结底，虽然胰岛素、液体和电解质的补充在DKA治疗中都很重要，但治疗的成功往往取决于一位关切且知识渊博的医生对患者进行仔细的逐小时监测。
