Cerebral Edema with Irreversible Coma in Severe Diabetic Ketoacidosis

THE number of deaths from severe diabetic acidosis has been significantly reduced in recent years with adequate insulin treatment and a better understanding of fluid and electrolyte balance. Experience at the Joslin Clinic has indicated a mortality of 3 to 5 per cent.1 However, deaths in 12 to 15 per cent of cases reported by those skilled in the treatment of diabetic ketoacidosis2 3 4 5 indicate a significantly higher mortality generally prevailing in most hospitals. Ordinarily, unless diagnosed late or handled inadequately, severe diabetic acidosis and coma are not fatal, and many of the deaths that continue to occur are related to . . .