Potassium Bicarbonate and Phosphate

Even though the body is potassium depleted, with a typical deficit of around 5 mmol/kg, initial potassium values are usually normal or elevated. Insulin therapy, rehydration and correction of acidosis all cause a decrease in serum potassium and 20-30 mmol potassium/h may be administered once potassium levels are below 5.0 mmol/L, provided renal function is intact. Subsequent potassium administration is guided by frequent concentration measurements; adjuvant oral administration may be used in very mild cases of DKA. It is a frequent practical problem that there may be some delay before values are available from the laboratory; gas analysers that provide instant bedside potassium concentrations greatly facilitate this process.

Bicarbonate use in DKA is a matter of controversy, but it is empirically recommended that 25-50 mmol sodium bicarbonate is given hourly for 1-2 h, if pH is below 7.0. Phosphate deficiency of around 1 mmol/kg is typically present in DKA, but there is no evidence that phosphate supplementation should be given routinely. In patients with severe hypophosphataemia and/or cardiac and skeletal muscle/respiratory weakness, 20-30 mmol of potassium phosphate can be given hourly for 1-2 h.

Diabetes Sustenance

Diabetes Sustenance

Get All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. This Book Is One Of The Most Valuable Resources In The World When It Comes To Learning How Nutritional Supplements Can Control Sugar Levels.

Get My Free Ebook


Post a comment