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March 2, 1979

Low- and High-Dose Intravenous Insulin Therapy for Diabetic Ketoacidosis

Author Affiliations

From the Division of Endocrinology, the Department of Internal Medicine of the University of Texas Health Science Center at San Antonio. Dr Gonzalez-Villalpando is now with the Division of Endocrinology and Metabolism, Department of Internal Medicine, Michael Reese Hospital, Chicago. Dr Blachley is now with the Division of Nephrology, Department of Medicine, University of Texas Southwestern Medical School, Dallas.

JAMA. 1979;241(9):925-927. doi:10.1001/jama.1979.03290350045023

We compared low-dose, continuous insulin infusion with a conventional high-dose intravenous bolus method of insulin administration in 18 episodes of diabetic ketoacidosis. The average rate of reduction in serum glucose concentration was 9.5±3.8%/hr in the continuous infusion group and 10.7± 4.7%/hr in the bolus group. Arterial blood pH was corrected to 7.35 by 9.9±2.6/hours in the continuous infusion group and by 10.4±3.2/hours in the bolus group. The above means are not significantly different between groups. By the time pH was corrected to 7.35, patients in the continuous infusion group had received 121±44 units of insulin, whereas those in the bolus group had received 326±152 units. The continuous low-dose insulin infusion method is as safe and efficacious as the conventional high-dose intravenous bolus method.

(JAMA 241:925-927, 1979)