Low rates of hyponatraemia in patients with diabetes treated with variable rate intravenous insulin infusion (VRIII)

Abstract

Aims: To investigate the risk of developing hyponatraemia or hypoglycaemia in individuals requiring variable rate intravenous insulin infusion (VRIII) using a protocol of variable rate insulin infused with 10% dextrose and 20 mmol/L potassium chloride.Methods: A prospective study was performed of 50 consecutive medical and surgical patients requiring VRIII. Sodium, potassium and glucose were measured before, during and after VRIII use.Results: Medical patients had significantly higher glucose values prior to VRIII. Glucose fell significantly in this group. Sodium concentrations were marginally low prior to commencing VRIII in seven medical and six surgical patients. One patient had significant hyponatraemia prior to VRIII (114 mmol/L) and this improved to 118 mmol/L during the VRIII. Overall there were no significant changes in sodium or potassium during VRIII. There were no significant differences in sodium or potassium between the two groups at any point.Conclusion: There was a low incidence of clinically significant hyponatraemia and hypokalaemia associated with a commonly used intravenous insulin regimen that combines insulin with 10% dextrose.