Emergency surgery and diabetic ketoacidosis

Diabetic ketoacidosis results from inadequate insulin dosage or increased insulin requirements, often precipitated by infection, trauma or surgical stress. Diabetics who require emergency surgery often have a grossly elevated blood glucose concentration and occasionally overt ketoacidosis. Such patients require rehydration, correction of sodium depletion, correction of subsequent potassium depletion and i.v. soluble (Humulin S) insulin by infusion at an initial rate of 4-8 unit h l. Initial...