Viktor Rosival
The identification of acetoacetic and beta-hydroxybutyrie acids in the urine of comatose patients with diabetic ketoacidosis at the end of the nineteenth century has led to the opinion that these two acids are the cause of lethal coma in diabetes mellitus (therefore the name “ketoacidotic coma”). In the following decades also other organic acids have been identified in such patients (up to date 34); there are no reports on the dependency of these 34 acids on insulin. Knowledge has emerged that acidosis (=low blood pH), regardless what is the acid (or acids), impairs utilization of glucose in brain cells: this could explain development of coma in patients with very low blood pH. The positive consequence of this development could be that increase and normalization of the very low blood-pH would be followed by recovery from coma to full alertness. Clinical reports have confirmed that infusions of alkalizing solutions resulted in recovery of comatose patients with diabetic ketoacidosis (=zero lethality).