To the Editor.—
We read the report of Arlan L. Rosenbloom, MD, and John I. Malone, MD (240:2462, 1978), concerning six diabetic children in whom ketone reagent strip failure resulted in a misdiagnosis of gastroenteritis instead of what proved to be diabetic ketoacidosis. A reply by the manufacturer, appended to the article, implied that these patients may have been responsible for the reagent strip failure by not following directions properly.We recently experienced a most distressing result of ketone reagent strip failure in a hospitalized adult diabetic patient in whom severe metabolic acidosis developed 36 hours after an elective surgical procedure.
Report of a Case.—
A 38-year-old obese woman had diabetes that was first diagnosed in 1970. At that time, she was poorly responsive to a short trial of insulin, but her condition was fairly well controlled for the next seven years with diet therapy and orally administered hypoglycemic drugs.