Crisis and Sodium Bicarbonate

Insulinization with saline infusion for 2 hours is usually sufficient to halt ketosis and gluconeogenesis and begin reversing metabolic acidosis. Rarely, life-threatening acidosis exists with pH below 6.90. Blood pressure and cardiac output may be compromised. The anion gap may be approaching 40 mEq/dL, suggesting a coexisting component of lactic acidosis. These are the extreme conditions that justify consideration of sodium bicarbonate (NaHCO3) infusion. The concern involves the serum potassium, which could shift intracellularly with a rapid rise in pH. If present, hyperka-lemia would be an overall benefit, but if the ECG is indeterminate or hypokalemia already exists, a further decline in serum potassium would be disastrous. Thus, administration of sodium bicarbonate should be done slowly with caution. Bolus therapy with 100 mEq NaHCO3 can also cause a transient hyperosmolality. with a potentially deleterious water shift in the brain. Sodium bicarbonate is more safely delivered isotonically as 100 mEq or 100 mL added to 1 L of 0.45% NS. The addition of the sodium would make this almost an isotonic solution, and delivery of bicarbonate ions in the large volume would preclude any sudden pH shifts.

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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