Continuous low-dose infusion of insulin in the treatment of diabetic ketoacidosis in children.
Twelve diabetic children--eight in ketoacidosis, three with insulin refractory hyperglycemia, and one postoperative patient--were treated with continuous, low-dose, intravenous infusion of insulin. The eight ketoacidotic children with a mean serum glucose concentration on admission of 631 mg/dl and bicarbonate value of 6.8 mM/1 were given regular insulin, 0.1 U/kg, slowly by bolus injection followed by a sustaining infusion of 0.1 U/kg/hour. Plasma glucose concentration fell at a mean rate of 82 mg/dl/hour. Euglycemia with concomitant improvement in the metabolic disorder was achieved with a mean dose of insulin, 0.68 U/kg, given over four to 10 hours. Mean plasma insulin in those children who had not previously received insulin was 55 muU/ml, well within the normal physiologic range. Growth hormone and serum triglyceride levels, low initially, rose with insulin therapy before returning to control values. Continuous low-dose insulin infusion is simple, safe, and effective, avoids confusion and empiricism, and appears to be the method of choice for the treatment of diabetic ketoacidosis or insulin resistance.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016883:Diabetic Ketoacidosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007263:Infusions, Parenteral; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D008297:Male
D007328:Insulin