Diabetic ketoacidosis. A review of cases at a university medical center.

Twenty-five cases of diabetic ketoacidosis were studied retrospectively with respect to clinical characteristics and results of therapy. In this series (as with all 88 patients admitted in the last five years with a diagnosis of diabetic ketoacidosis) there were no deaths. Infection was found to be the most common precipitating event, documented by physical findings and cultures in one-third of these cases. In about two-thirds of the cases, electrocardiograms which were read as abnormal on admission reverted to normal after therapy. In all patients serum potassium levels decreased from admission values; one patient became symptomatically hypokalemic. Low serum potassium levels on admission and early vigorous bicarbonate therapy are emphasized as major predisposing factors of symptomatic hypokalemia. None of the patients had overt hyperosmolar coma, lactic acidosis or cerebral edema during therapy.