TREATMENT OF DIABETIC COMA WITH LOW-DOSE INJECTIONS OF INSULIN

  • 1 January 1976
    • journal article
    • research article
    • Vol. 67  (2) , 230-239
Abstract
Patients (21) in severe diabetic coma were treated with small doses of insulin at a rate of 4.1 units/h (total dose about 100 units/24 h). Using single doses of 4-10 units by the i.v. or i.m. routes the fall of blood glucose was steady in all cases. In the treatment of diabetic coma this regimen of insulin administration was simple, safe and effective since 1946. Main dangers during recompensation of diabetic coma are: hypovolemia with oliguria: anuria, disequilibrium syndrome with cerebral edema and hypokalemia. Early intensive and adequate i.v. fluid and electrolyte replacement is the most important part of treatment. Most of the cases in this study were undiagnosed diabetics (14) and elderly patients (9). Three patients older than 65 yr and a 56 yr old diabetic died. In this context the most important aspects of treatment to avoid death are prevention of diabetic coma and adequate fluid and electrolyte replacement especially in geriatric patients.

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