title: Weight-based insulin dosing for acute hyperkalemia results in less hypoglycemia.
abstract: Hyperkalemia treatment with intravenous insulin has been associated with hypoglycemia. This single-center, retrospective study compared the effects on hypoglycemia between weight-based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) compared to standard flat doses of 10 U among patients weighing less than 95 kg. Of the 132 charts randomly selected for review, hypoglycemic events (blood glucose <70 mg/dL) were reduced from 27.3% in the 10-U group to 12.1% in the weight-based group (P = 0.05). The number of affected patients was reduced with 19.7% in the 10-U group and 10.6% in the weight-based group (P = 0.22). The potassium-lowering effects of these 2 strategies were similar between groups. Female patients and those with baseline glucose values <140 mg/dL were at increased risk for hypoglycemia. Weight-based insulin dosing (0.1 U/kg) for acute hyperkalemia therapy resulted in less hypoglycemia without impacting potassium lowering. Journal of Hospital Medicine 2016;11:355-357. © 2016 Society of Hospital Medicine.
authors.affiliation: St. Louis College of Pharmacy, St. Louis, Missouri.
authors.forename: Dauria T
authors.initials: DT
authors.lastname: Wheeler
authors.affiliation: Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Schafers
authors.affiliation: Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Tim A
authors.initials: TA
authors.lastname: Horwedel
authors.affiliation: Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Eli N
authors.initials: EN
authors.lastname: Deal
authors.affiliation: Diabetes Center, Washington University in St. Louis Medical School, St. Louis, Missouri.
authors.forename: Garry S
authors.initials: GS
authors.lastname: Tobin
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects*; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy*; D007003:Hypoglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin