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Phosphate therapy in diabetic ketoacidosis.
Arch Intern Med. 1982 Mar; 142(3):517-20.AI

Abstract

To determine the efficacy of phosphate replacement in the therapy for diabetic ketoacidosis (DKA), 44 patients were randomly assigned to three treatment groups: those who received no phosphate replacement, those who received 15 mmole of sodium phosphate at the fourth hour, or those who received 15 mmole of sodium phosphate at 2, 6, and 10 hours. All patients were treated with intravenous insulin injection (0.1 units/kg/hr), fluids, and potassium. Four hours after a 15-mmole sodium phosphate infusion, the serum phosphate level was 2.8 +/- 0.8 mg/dL vs 2.1 +/- 0.8 mg/dL in the control patients; however, this dose was insufficient to maintain the serum phosphate level at 16 and 24 hours. Forty-five millimoles of phosphate prevented severe hypophosphatemia in all but one patient and produced substantially higher phosphate levels at 8, 16, and 24 hours. Phosphate therapy did not affect the duration of DKA, dose of insulin required to correct the acidosis, abnormal muscle enzyme levels, glucose disappearance, or morbidity and mortality. Although theoretically appealing, phosphate therapy is not an essential part of the therapy for DKA in most patients.

Authors

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Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

6802095

Citation

Wilson, H K., et al. "Phosphate Therapy in Diabetic Ketoacidosis." Archives of Internal Medicine, vol. 142, no. 3, 1982, pp. 517-20.
Wilson HK, Keuer SP, Lea AS, et al. Phosphate therapy in diabetic ketoacidosis. Arch Intern Med. 1982;142(3):517-20.
Wilson, H. K., Keuer, S. P., Lea, A. S., Boyd, A. E., & Eknoyan, G. (1982). Phosphate therapy in diabetic ketoacidosis. Archives of Internal Medicine, 142(3), 517-20.
Wilson HK, et al. Phosphate Therapy in Diabetic Ketoacidosis. Arch Intern Med. 1982;142(3):517-20. PubMed PMID: 6802095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phosphate therapy in diabetic ketoacidosis. AU - Wilson,H K, AU - Keuer,S P, AU - Lea,A S, AU - Boyd,A E,3rd AU - Eknoyan,G, PY - 1982/3/1/pubmed PY - 1982/3/1/medline PY - 1982/3/1/entrez SP - 517 EP - 20 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 142 IS - 3 N2 - To determine the efficacy of phosphate replacement in the therapy for diabetic ketoacidosis (DKA), 44 patients were randomly assigned to three treatment groups: those who received no phosphate replacement, those who received 15 mmole of sodium phosphate at the fourth hour, or those who received 15 mmole of sodium phosphate at 2, 6, and 10 hours. All patients were treated with intravenous insulin injection (0.1 units/kg/hr), fluids, and potassium. Four hours after a 15-mmole sodium phosphate infusion, the serum phosphate level was 2.8 +/- 0.8 mg/dL vs 2.1 +/- 0.8 mg/dL in the control patients; however, this dose was insufficient to maintain the serum phosphate level at 16 and 24 hours. Forty-five millimoles of phosphate prevented severe hypophosphatemia in all but one patient and produced substantially higher phosphate levels at 8, 16, and 24 hours. Phosphate therapy did not affect the duration of DKA, dose of insulin required to correct the acidosis, abnormal muscle enzyme levels, glucose disappearance, or morbidity and mortality. Although theoretically appealing, phosphate therapy is not an essential part of the therapy for DKA in most patients. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/6802095/Phosphate_therapy_in_diabetic_ketoacidosis_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/142/pg/517 DB - PRIME DP - Unbound Medicine ER -