Small Doses of Intramuscular Insulin in the Treatment of Diabetic " Coma "

Alberti, K. G. M. M.; Hockaday, T. D. R.; Turner, R. Elaine

doi:10.1016/s0140-6736(73)92346-5

Cited by 160 publications

(74 citation statements)

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“…A lthough positive therapeutic responses to low-dose insulin therapy have been established in adult patients with diabetic ketoacidosis (DKA) (1)(2)(3)(4)(5)(6)(7)(8), none of these studies and guidelines for the treatment of DKA, including the American Diabetes Association (ADA) Consensus and Position Statements, has ever assessed or addressed the use of a continuous insulin infusion without a loading dose of insulin (9). In the current study, we used a dose of 0.14 unit ⅐ kg Ϫ1 ⅐ h Ϫ1 without a loading dose instead of the recommended 0.1 unit ⅐ kg Ϫ1 ⅐ h Ϫ1 with a loading dose.…”

mentioning

confidence: 99%

Is a Priming Dose of Insulin Necessary in a Low-Dose Insulin Protocol for the Treatment of Diabetic Ketoacidosis?

et al. 2008

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OBJECTIVE—The purpose of this study was to assess the efficacy of an insulin priming dose with a continuous insulin infusion versus two continuous infusions without a priming dose. RESEARCH DESIGN AND METHODS—This prospective randomized protocol used three insulin therapy methods: 1) load group using a priming dose of 0.07 units of regular insulin per kg body weight followed by a dose of 0.07 unit · kg−1 · h−1 i.v. in 12 patients with diabetic ketoacidosis (DKA); 2) no load group using an infusion of regular insulin of 0.07 unit · kg body weight−1 · h−1 without a loading dose in 12 patients with DKA, and 3) twice no load group using an infusion of regular insulin of 0.14 · kg−1 · h−1 without a loading dose in 13 patients with DKA. Outcome was based on the effects of insulin therapy on biochemical and hormonal changes during treatment and recovery of DKA. RESULTS—The load group reached a peak in free insulin value (460 μU/ml) within 5 min and plateaued at 88 μU/ml in 60 min. The twice no load group reached a peak (200 μU/ml) at 45 min. The no load group reached a peak (60 μU/ml) in 60–120 min. Five patients in the no load group required supplemental insulin doses to decrease initial glucose levels by 10%; patients in the twice no load and load groups did not. Except for these differences, times to reach glucose ≤250 mg/dl, pH ≥7.3, and HCO3− ≥15 mEq/l did not differ significantly among the three groups. CONCLUSIONS—A priming dose in low-dose insulin therapy in patients with DKA is unnecessary if an adequate dose of regular insulin of 0.14 unit · kg body weight−1 · h−1 (about 10 units/h in a 70-kg patient) is given.

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confidence: 99%

Is a Priming Dose of Insulin Necessary in a Low-Dose Insulin Protocol for the Treatment of Diabetic Ketoacidosis?

et al. 2008

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“…The most important point in the treatment of DKA involves insulin administration. There was major concern about; physiologic or low dose insulin therapy was superior to pharmacologic dose regimen and the administration of regular insulin via continuous intravenous infusion or by frequent subcutaneous or intramuscular injections [10,[157][158][159][160]. Several randomized controlled studies have shown that physiologic or low dose insulin therapy was superior to pharmacologic dose regimen and low-dose insulin therapy is effective regardless of the route of administration in DKA [118,159,160].…”

Section: Insulin Therapymentioning

confidence: 99%

Diabetic Ketoacidosis

Cesur¹,

Sayi²

2013

Type 1 Diabetes

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“…Cada grupo do PSF, composto por médico, enfermeiro, auxiliar de enfermagem e 4 a 6 agentes comunitários, atinge em média cerca de 800 a 1000 famílias e recebe de R$ 28.000,00 a R$ 54.000,00 do SUS por ano (além de R$ 1.500,00 por agente comunitário) 1 . Em junho de 2000, o PACS cobria mais de 26 milhões de brasileiros e o PSF quase 10 milhões.…”

Section: D D D Di Retrizes Iretrizes Iretrizes Iretrizes Iretrizesunclassified

Normas para redução da mortalidade materna

Vega¹

2001

Rev. Assoc. Med. Bras.

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Small Doses of Intramuscular Insulin in the Treatment of Diabetic " Coma "

Cited by 160 publications

References 20 publications

Is a Priming Dose of Insulin Necessary in a Low-Dose Insulin Protocol for the Treatment of Diabetic Ketoacidosis?

Is a Priming Dose of Insulin Necessary in a Low-Dose Insulin Protocol for the Treatment of Diabetic Ketoacidosis?

Diabetic Ketoacidosis

Normas para redução da mortalidade materna

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