Low-dose insulin in the treatment of diabetic ketoacidosis

Publisher Website
Google Scholar
Abstract
Severe diabetic ketoacidosis remains a lethal condition. Many deaths occur during therapy and are avoidable. Treatment includes rehydration, administration of insulin and K and clinical care. For many years very large doses of insulin were used. Such large doses are probably unnecessary and lead to undue hypokalemia, hypoglycemia and osmotic disequilibria. Low doses of insulin given as continuous i.v. infusions (4-10 units/h) or as hourly i.m. injections (20 units initially, then 5 units/h) apparently are as effective as large doses in treating severe ketoacidosis. The new regimens are simple to use, predictable and safe. K shifts are less than with large insulin doses, and insulin resistance is a relatively minor problem. The new regimens are particularly suitable for use in nonspecialist centers.