Related Experiment Videos
[Diabetic ketoacidosis: results with two different patterns of insulin administration (author's transl)]
Insights
Continuous insulin infusion and subcutaneous injections are equally effective for treating diabetic ketoacidosis in children. Continuous infusion offers simpler management and fewer hypoglycemic episodes, with a suggested subcutaneous dose to prevent rebound hyperglycemia.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus.
- Effective insulin therapy is crucial for managing DKA in pediatric patients.
- Different insulin administration methods require evaluation for optimal DKA treatment.
Purpose of the Study:
- To compare the effectiveness of continuous insulin infusion versus subcutaneous insulin administration in pediatric DKA.
- To assess the safety and ease of management for each insulin delivery method.
- To identify strategies for preventing hyperglycemia rebound and managing discordance between glucose and acidosis correction.
Main Methods:
- A comparative study involving 15 children diagnosed with DKA.
- Group 1: Nine patients received continuous intravenous insulin infusion.
- Group 2: Six patients received subcutaneous insulin, with an initial intravenous bolus for half the first dose.
Main Results:
- Both continuous insulin infusion and subcutaneous insulin administration demonstrated equal effectiveness in treating DKA.
- Continuous insulin infusion was found to be simpler and easier for overall glycemic control.
- Continuous infusion helped prevent hypoglycemic episodes more effectively than the subcutaneous method.
Conclusions:
- Continuous insulin infusion is a viable and effective method for treating pediatric DKA.
- A subcutaneous insulin dose post-infusion is recommended to prevent hyperglycemic rebound.
- Adjusting insulin infusion rates can correct discordance between hyperglycemia and acidosis correction.
Abstract:
The response to insulin treatment in 15 children with diabetic ketoacidosis is studied. Insulin continous infusion was administered to nine patients. The other six patients received insulin subcutaneously except one half of the first dose injected by vein as a bolus. Both patterns of insulin administration proved to be equally effective. Anyway the insulin continuous infusion appears as a simple and easier method for a good general control and to prevent hypoglycemic episodes. To prevent a hyperglycemic rebound it is suggested that a dose of subcutaneous insulin must be injected immediately after the insulin infusion is discontinued. A discordance between hyperglycemia correction and the degree of acidosis has been noticed in some patients; this can be corrected decreasing insulin infusion rate.