THE ETIOLOGY OF DIABETIC ACIDOSIS

Abstract

Early in the history of the study of diabetic coma it became apparent that acidosis plays an important part in the production of this syndrome. Subsequently it was demonstrated that this state is due primarily to the accumulation of large amounts of organic acids in the tissues, particularly beta-hydroxybutyric and acetoacetic acids, and that the excretion of these, together with smaller amounts of other organic acids, results in a depletion of base. The loss of base causes a dehydration and intensifies the acidosis and a vicious cycle ensues. For some time minor controversies occurred with reference to the relative importance of the acidosis or the toxic effects of the acetone bodies themselves in the production of the coma. Today the physician is aware that both are important. In view of the predominant role of the acetone bodies in the development of diabetic acidosis and coma it became of interest to