The article 'Diabetic ketoacidosis: principles of management' by Sharma and Hadebe (vol 68(3), 2007, p. 184) contains several discrepancies. The authors write 'The basic mechanism for the development of [diabetic ketoacidosis] DKA is a reduction in the effective insulin concentration and increased counter-regulatory hormones ...'. Schade et al (1981) refer to 12 papers reporting sufficient amounts of insulin in plasma of patients witii DKA. Sharma and Hadebe also write 'Euglycaemic DKA has been reported in up to 18% of cases' ?euglycae-mia is identical to euinsulinaemia. Where are die published reports on the lack of insulin in patients with DKA? According to Waldhausl et al (1979), 'increased counter-regulatory hormones' are die consequence of DKA, not its cause.
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