Experience with low-dose insulin infusion in diabetic ketoacidosis and diabetic hyperosmolarity

1978 ◽  
Vol 138 (1) ◽  
pp. 60-62 ◽  
Author(s):  
R. Bendezu
Keyword(s):  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Low Dose

Effectiveness of low-dose continuous intravenous insulin infusion in diabetic ketoacidosis

1977 ◽  
Vol 91 (5) ◽  
pp. 701-705 ◽  
Author(s):  
George A. Edwards ◽  
Edward C. Kohaut ◽  
Barbara Wehring ◽  
L. Leighton Hill
Keyword(s):  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Low Dose ◽  
Intravenous Insulin

scholarly journals TREATMENT OF DIABETIC KETOACIDOSIS (DKA) WITH CONTINUOUS LOW-DOSE INSULIN INFUSION

1977 ◽  
Vol 11 (4) ◽  
pp. 429-429
Author(s):  
Michael Nussbaum ◽  
Cyril A L Abrams ◽  
Ronald Shenker ◽  
Philip Lanzkowsky
Keyword(s):  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Low Dose

Discordant Correction of Hyperglycemia and Ketoacidosis With Low-Dose Insulin Infusion

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 125-127
Author(s):  
William V. Tamborlane ◽  
Myron Genel
Keyword(s):  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Half Life ◽  
Insulin Infusion ◽  
Low Dose ◽  
Insulin Dosage ◽  
Safety And Efficacy ◽  
Short Half Life ◽  
Dose Infusion ◽  
Practicing Physicians

Since the appearance of several reports concerning the safety and efficacy of continuous low-dose infusion of insulin in the treatment of diabetic ketoacidosis,1-3 the method has received considerable acceptance. Several advantages have been cited. It provides a standardized insulin dosage. The short half-life of intravenously administered insulin allows for sufficient flexibility so that with proper monitoring, hypoglycemia can be avoided. The more physiologic levels of insulin achieved may decrease the risks of developing both hypokalemia and cerebral edema.4 Madison, however, after reviewing the evidence supporting this method, cautioned that the data available were too scanty to justify its general use by practicing physicians.5

Cerebral Edema and Ophthalmoplegia Reversed by Mannitol in a New Case of Insulin-Dependent Diabetes Mellitus

PEDIATRICS ◽  
1982 ◽  
Vol 69 (1) ◽  
pp. 87-90
Author(s):  
Bonita Franklin ◽  
John Liu ◽  
Fredda Ginsberg-Fellner
Keyword(s):  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Insulin Infusion ◽  
Low Dose ◽  
Insulin Dependent Diabetes Mellitus ◽  
Dependent Diabetes Mellitus ◽  
Fluid Restriction ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Continuous Insulin Infusion

Cerebral edema is a sometimes fatal complication of diabetic ketoacidosis which occurs unpredictably and when biochemical parameters show improvement. A case of a young, newly diagnosed insulin-dependent diabetic boy who developed this complication while receiving a low-dose continuous insulin infusion is reported. Two hours after treatment signs of headache, ophthalmoplegia, and blurred disc margins suggested early cerebral edema. Despite fluid restriction, avoidance of alkali, and phosphate supplementation, cerebral edema ensued three hours later. This complication was then reversed by administration of mannitol. Our patient's ophthalmoplegia, unlike typical diabetic ophthalmoplegia, improved immediately and completely resolved within two weeks after this episode. It is concluded that the use of mannitol in the cerebral edema of diabetic ketoacidosis is beneficial if it is instituted promptly.

Low-Dose Intravenous Insulin Infusion Versus Subcutaneous Insulin Injection: A Controlled Comparative Study of Diabetic Ketoacidosis

PEDIATRICS ◽  
1977 ◽  
Vol 59 (5) ◽  
pp. 733-738
Author(s):  
Stenvert L. S. Drop ◽  
Bertrand J. M. Duval-Arnould ◽  
Alan E. Gober ◽  
Joseph H. Hersh ◽  
Paul T. McEnery ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Low Dose ◽  
Insulin Injection ◽  
Serum Glucose ◽  
Constant Infusion ◽  
Control Group ◽  
Study Group ◽  
Insulin Administration ◽  
Intravenous Insulin

Fourteen patients, 5 to 17 years old, with 18 episodes of uncomplicated diabetic ketoacidosis were randomly allocated and studied prospectively. The study group received 0.1 units of insulin per kilogram of body weight per hour as a continuous intravenous infusion: the control group received insulin subcutaneously. In both groups, a gradual fall in serum glucose and ketone levels was achieved. Serum ketones persisted longer in the intravenous group. No complications were encountered. The study suggests that both regimens of insulin administration are equally effective, but a low-dose constant infusion may provide more simplified and controlled management than the standard subcutaneous regimen.

Low-Dose Intravenous Insulin Infusion in Patients With Diabetic Ketoacidosis: Biochemical Effects in Children

PEDIATRICS ◽  
1977 ◽  
Vol 60 (5) ◽  
pp. 681-688
Author(s):  
Elmer S. Lightner ◽  
Michael S. Kappy ◽  
Betty Revsin
Keyword(s):  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Low Dose ◽  
Elevated Serum ◽  
Immunoreactive Insulin ◽  
Bicarbonate Level ◽  
Plasma Glucagon ◽  
Biochemical Alterations ◽  
Biochemical Effects ◽  
Intravenous Insulin

Twenty-five episodes of diabetic ketoacidosis in 20 children were treated with continuous low-dose intravenous insulin infusion. Stable serum immunoreactive insulin concentrations were produced, along with prompt falls in glucose, β-hydroxybutyrate, and glucagon levels, and a steadily increasing bicarbonate level. Neither hypokalemia nor hypophosphatemia developed. Elevated serum alanine concentrations were found during ketoacidosis in contrast to the lowered concentrations found in adults, and were correlated inversely with plasma glucagon concentrations. The treatment regimen described is safe, easy to use, efficacious, and resulted in prompt correction of the observed biochemical alterations in children with diabetic ketoacidosis.

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