Diabetic ketoacidosis in a district general hospital, 1981-1986

The outcome of therapy of poorly controlled insulin-requiring cases of diabetes mellitus needing admission to a district general hospital from 1981 to 1986 was examined. There were 156 admissions to the hospital, 17 of these classified as severe diabetic ketoacidosis (serum standard bicarbonate less than 14 mmol/l). A 'low dose' insulin regimen was used in each case of severe ketoacidosis. No patient who was admitted died within a six-month period. These figures emphasise the value of a policy of direct hospital admission for poorly controlled diabetics and suggest that early diagnosis in general practice is vital to allow the application of relatively simple and standard hospital treatment.