Rational management of diabetic ketoacidosis.

After a definite diagnosis, rational management begins with the construction of a grid flow sheet on which can be recorded vital signs, urine sugar and acetone, blood glucose and electrolytes, arterial blood gases and treatment (fluids, insulin, potassium). Fluids correct the hyperosmolar state, sodium deficit and hypovolemia. Hypokalemia is aggravated by insulin therapy and potassium levels must be monitored chemically and with the electrocardiogram. High-dose and low-dose insulin regimens have been used. Sudden hypoglycemia must be avoided.