From published reports, including this one, it might be concluded that the formerly high death rate from acidosis and coma in juvenile diabetics1-3 is reaching the vanishing point.4-11 Such complacency is unjustified. Diabetes mellitus is the eighth cause of death in the 1- to 14-year age group,12 and, though specific diagnoses are not available, it is highly probable that almost all of these deaths occur in acidosis and coma. These isolated fatalities, largely unreported in the pediatric literature, account for the bulk of more than 3000 deaths recorded during the past decade.13 It is reasonable to presume that such deaths are largely preventable. We have reviewed our series of acidosis and coma for principles that might be applicable to these fatalities.
Materials and Methods
Criteria for the diagnosis of diabetic ketosis, acidosis, and coma vary.4-6,10,14,15 To provide objective standards for comparison, we divide our cases