Use of sodium bicarbonate and blood gas monitoring in diabetic ketoacidosis: A review

Figure 1 The pathophysiology of diabetic ketoacidosis. Decreased insulin sensitivity leads to increased concentrations of counter-regulatory hormones which promote catabolism of proteins and adipocytes. The production of free amino acids leads to the stimulation of gluconeogenesis and glycogenolysis leading to hyperglycemia. Free fatty acids undergo oxidation in the mitochondria and result in ketone production leading to acidosis. FFA: Free fatty acids.