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March 19, 1973

Constant Intravenous Insulin Infusion in Diabetic Ketoacidosis

JAMA. 1973;223(12):1348-1351. doi:10.1001/jama.1973.03220120020004

Insulin administration by continuous intravenous infusion was evaluated in the therapy of diabetic ketoacidosis. A priming intravenous injection of 50 units followed by continuous infusion of 50 units/hr was employed as a standard protocol. Irrespective of severity, all patients showed clear-cut biochemical and clinical response. Plasma β-hydroxybutyrate levels fell from 11.3 millimols/liter to 1.1 millimols/liter during four to ten hours. Plasma glucose level declined to approximately 300 mg/100 ml or less in an average of five hours. No deaths occurred and there were no complications specifically attributable to this mode of therapy. There are advantages to a standard protocol delivering all insulin by continuous infusion.