Intravenous administration of sodium bicarbonate was first used in the treatment of diabetic ketosis in 18861; although it has been a recognized procedure in most clinics for the ensuing fifty-five years, there is even yet little agreement as to its efficacy. Of the various reasons for this discrepancy, one is most apparent. So many different prognostic and therapeutic factors influence the outcome of the disease that evaluation of any single procedure, such as administration of sodium bicarbonate, is rendered difficult. The purpose of this paper is twofold, to discuss the effect of intravenous administration of sodium bicarbonate on blood sugar, carbon dioxide—combining power and ketones in the blood and urine during the treatment of diabetic ketosis and to report the effect of sodium bicarbonate therapy on coma mortality in 154 cases of ketosis, which were classified in five groups according to severity of the condition.
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