Abstract
Recent studies in adults have shown the efficiency and safety of continuous low-dose intravenous insulin in the treatment of diabetic ketoacidosis. Little data has been reported in pediatrfe patients.
Fourteen consecutive children presented in diabetic ketoacidosis. Six were newly diagnosed diabetics. The average admission blood glucose concentration was 806 mg/dl and the mean admission capillary blood pH was 7.13. All patients were given intravenous fluids and continuous low-dose intravenous insulin at a dose of 0.06 units/kg/hr. Fresh insulin solutions were prepared every four hours. Human serum albumin and sodium bicarbonate were not used. There were two critical times in the management of each patient; the first when the blood glucose concentration declined to 300 mg/dl. At this time the I.V. fluids were changed to a glucose containing solution. The average time needed to obtain this blood glucose concentration was 5.7 hr. The second critical time was when the capillary blood pH reached 7.35. At this time intravenous insulin was discontinued. The average duration of intravenous insulin therapy was 9.8 hr. The accumulated dose of intravenous insulin was 0.6 u/kg. The patient was then switched to subcutaneous insulin, .25-.5 u/kgm every 4 hours. No complications were observed. This method was found to be safe and effective.
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Veeser, T., Glines, M., Niederman, L. et al. LOW-DOSE INTRAVENOUS INSULIN THERAPY FOR DIABETIC KETOACIDOSIS IN CHILDREN. Pediatr Res 11, 524 (1977). https://doi.org/10.1203/00006450-197704000-00923
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DOI: https://doi.org/10.1203/00006450-197704000-00923
