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Diabetic Ketoacidosis > Drug Therapy Author: Heather Lochnan, MD
Approved for review - 2009-03-25
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Rationale:

  • Bicarbonate therapy remains controversial and the benefits of bicarbonate, even if pH is <7.0, are not clear.

Evidence:

  • Numerous studies have shown the lack of benefit of bicarbonate therapy in patients with DKA (29; 30; 31).
  • The American Diabetes Association recommendations from January 2001 suggest the use of bicarbonate if pH 7.0 or less (18).
  • Note that bicarbonate therapy in children may be even more controversial (32).
  • A case report showed the benefit of bicarbonate therapy in a patient with pH <6.9 (33).

Comments:

  • None.
FAQs
Ebenezer A. Nyenwe, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Heather Lochnan, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given.

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