Hypothermia: a complication of diabetic ketoacidosis. Issue 6149 (18th November 1978)

• Record Type: Journal Article
• Authors: Gale, E A; Tattersall, R B
• Is Part Of: BMJ. Volume 2:Issue 6149(1978)
• Page Start: 1387
• Page End: 1389
• Publication Date: 1978-11-18
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.2.6149.1387
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract : During 1969-77, 20 episodes of severe hypothermia occurred in 19 diabetic patients in Nottingham. Thirteen were associated with ketotic hyperosmolar coma, two with lactic acidosis, and one with hypoglycaemia, while in four there was no loss of diabetic control. Ketoacidosis accounted for 11.8% of all admissions for severe accidental hypothermia and was a commoner cause than hypothyroidism (8%). Patients with ketoacidosis were younger and developed hypothermia as often during the summer as during the winter. The metabolic disturbance was characteristic, with severe acidosis (mean pH 7.04), a high blood glucose concentration (mean 56.6 mmol/l; 1020 mg/100 ml), and high plasma osmolality (mean 379.7 mmol (mosmol)/kg). Eight of the 13 episodes proved fatal. Hypothermia may aggravate ketoacidosis and complicate treatment and should be sought in all patients with severe diabetic coma.