Cerebral Edema and Diabetic Ketoacidosis
Authors: ROBERT MATZ
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 July 1982Cerebral Edema and Diabetic KetoacidosisROBERT MATZ, M.D., PATRICIA CARROLL, M.D.ROBERT MATZ, M.D.Search for more papers by this author, PATRICIA CARROLL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-1-141_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We write to comment on the article by Fein and associates (1). From information reported by Clements and colleagues (2), which confirmed our own observations, we suspect that an element of "benign" cerebral edema occurs quite frequently, if not routinely, during successful treatment of uncontrolled diabetes. In fact, it used to be common to expect deterioration of the initial state of consciousness in 10% to 15% of diabetic patients in ketoacidosis early in therapy. This event is much less common currently with low-dose insulin regimens; early potassium, phosphate, and magnesium replacement; and large volumes of crystalloid infusions....References1. FEIN I, RACKOW E, SPRUNG C, and GRODMAN R. Relation of colloid osmotic pressure to arterial hypoxemia and cerebral edema during crystalloid volume loading of patients with diabetic ketoacidosis. Ann Intern Med. 1982;96:570-5. LinkGoogle Scholar2. CLEMENTS R, BLUMENTHAL S, MORRISON A, and WINEGRAD A. Increased cerebrospinal fluid pressure during treatment of diabetic ketosis. Lancet. 1971;12:671-5. CrossrefGoogle Scholar3. DEFRONZO R, COOKE C, ANDRES R, FALOONA G, and DAVIS P. The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest. 1975;55:845-55. CrossrefMedlineGoogle Scholar4. GUNDERSON H and CHRISTENSEN N. Intravenous insulin causing loss of intravascular water and albumin and increased adrenergic nervous activity in diabetics. Diabetes. 1977;26:551-7. CrossrefMedlineGoogle Scholar5. BLUMENTHAL S. Observations on sodium retention related to insulin treatment of experimental diabetes. Diabetes. 1975;24:645-9. CrossrefMedlineGoogle Scholar1. FEIN I, RACKOW E, SPRUNG C, and GRODMAN R. Relation of colloid osmotic pressure to arterial hypoxemia and cerebral edema during crystalloid volume loading of patients with diabetic ketoacidosis. Ann Intern Med. 1982;96:510-5. LinkGoogle Scholar2. WILLIAMS R. The pancreas. In: WILLIAMS RH, ed. Textbook of Endocrinology. 4th ed. Philadelphia: W.B. Saunders Company; 1968:613-802. Google Scholar3. WINEGRAD A and MORRISON A. Diabetic ketoacidosis, non-ketotic hyperosmolar coma and lactic acidosis. In: DEGROOT LJ, ed. Endocrinology. Vol. 2. New York: Grune & Stratton; 1979:1025-40. Google Scholar4. PORTE D and HALTER J. The endocrine pancreas and diabetes mellitus. In: WILLIAMS RH, ed. Williams Textbook of Endocnnology. 6th ed. Philadelphia: W.B. Saunders Company; 1981:716-843. Google Scholar5. MCCURDY D. Hyperosmolar hyperglycemic nonketotic diabetic coma. Med Clin North Am. 1970;54:683-99. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT MATZ, M.D.; PATRICIA CARROLL, M.D.Affiliations: Montefiore-North Central Bronx Hospital Bronx, NY 10467 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCerebral edema in diabetic ketoacidosisCerebral oedema during treatment of diabetic ketoacidosis: are we any nearer finding a cause?CEREBRAL OEDEMA IN DIABETIC KETOACIDOSIS 1 July 1982Volume 97, Issue 1Page: 141-142KeywordsConsciousnessEdemaInsulinMagnesiumPhosphatesPotassium ePublished: 1 December 2008 Issue Published: 1 July 1982 PDF downloadLoading ...