SEVERE DIABETIC METABOLIC DECOMPENSATION IN THE ELDERLY

Abstract
Of 211 episodes of severe diabetic metabolic decompensation, 27 (13 per cent) occurred in patients aged 60 years or more. In 26 of the latter one or more precipitating cause was found, infection being the most common. The initial clinical features and biochemical details and those after 24-hours treatment are described and the rationale of therapy discussed. Only one patient, admitted moribund, failed to survive the initial metabolic disturbance. Five others died, for reasons generally attributable to vascular disease. Our experience emphasizes the value of close biochemical monitoring and the importance of excluding reversible precipitating factors, especially infection, in such elderly patients.

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