[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]
[IP] low blood sugar treatment can kill
Want to send this story to another AOL member? Click on the heart at the top
of this window.
Low-blood sugar diabetes treatment can kill-study
Release at 5 P.M. (2200 GMT)
By Gene Emery
BOSTON, Jan 24 (Reuters) - A common treatment for diabetic children whose
blood sugar has fallen too low can cause fatal brain swelling, researchers
from the University of California at Davis School of Medicine warned in
Thursday's New England Journal of Medicine.
The treatment involves giving the children a sodium bicarbonate injection to
youngsters whose blood sugar level is too low, a condition known as diabetic
In a study of 6,977 medical records spanning 15 years, the UC Davis team led
by Dr. Nicole Glaser found that the bicarbonate therapy increases the
likelihood that the brain will begin to swell.
Although such swelling occurs in only 1 percent of the children suffering
from diabetic ketoacidosis, it is fatal in as many as 9 out of 10 youngsters
who develop it. Those who survive often suffer permanent brain damage.
Such brain swelling, called cerebral edema, is responsible for up to 60
percent of diabetes-related deaths in children.
Dr. Nathan Kuppermann, an author of the research, said this is the first
study to confirm the suspicion that treatment with bicarbonate -- essentially
baking soda -- can be extremely dangerous.
"I imagine doctors in emergency departments and pediatric intensive care
units will put this knowledge into effect immediately," said Kuppermann, in a
statement released by UC Davis.
Doctors give bicarbonate in hopes of neutralizing the acids in the blood that
rise to toxic levels when blood sugar levels drop too far, producing the
fatigue, thirst, nausea, labored breathing and confusion that are hallmarks
of ketoacidosis. The problem requires emergency medical treatment.
About 25 to 40 percent of children with diabetes don't realize they have the
disease until they develop ketoacidosis.
Glaser, in an interview with Reuters, warned against using the treatment on
"There are some specific situations where you might want to use bicarbonate
because it might be life-saving. It's just that in the standard child with
diabetic ketoacidosis, it shouldn't be used," she said.
The researchers said they also discovered that children whose blood shows low
levels of carbon dioxide and high levels of urea nitrogen face the highest
risk for brain swelling.
Glaser said she hopes doctors can use that information "to better monitor the
high-risk children, and pick up the initial signs of (cerebral edema) before
it progresses to a more serious stage."
In such cases, drugs to reduce the swelling can be given.
But it was not clear whether the findings applied to adults because "adults
don't seem to get cerebral edema," Glaser said.
Copyright 2001 Reuters Limited. All rights reserved. Republication or
redistribution of Reuters content, including by framing or similar means, is
expressly prohibited without the prior written consent of Reuters. Reuters
shall not be liable for any errors or delays in the content, or for any
actions taken in reliance thereon. All active hyperlinks have been inserted
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml