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Higher-Than-Conventional Subcutaneous Regular Insulin Doses Following Diabetic Ketoacidosis in Children and

Özlem Bağ1, Selma Tunç, Özlem Nalbantoğlu

  • 1Dr. Behçet Uz Children's Hospital, Clinic of Pediatrics, İzmir, Turkey, Phone: +90 232 464 6167

Journal of Clinical Research in Pediatric Endocrinology
|January 4, 2017
PubMed

Insights

A higher initial dose of regular insulin (1.4-1.5 U/kg/day) after diabetic ketoacidosis (DKA) improves glycemic control in children and adolescents. This approach enhances blood glucose management without increasing hypoglycemia risk.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of diabetes requiring intensive management.
  • Establishing optimal insulin dosing post-DKA is crucial for preventing recurrence and ensuring stable glycemic control.
  • Subcutaneous regular insulin therapy is a common treatment modality after initial DKA resolution.

Purpose of the Study:

  • To determine the impact of initial subcutaneous regular insulin dosage on glycemic control within the first 48 hours following diabetic ketoacidosis (DKA) resolution.
  • To compare glycemic outcomes between different initial insulin dose regimens in pediatric patients.

Main Methods:

  • Retrospective review of 76 pediatric patients hospitalized with DKA over 3 years.
  • Patients were divided into two groups based on initial subcutaneous insulin dose: higher dose (median 1.45 U/kg/day) and lower dose (median 0.96 U/kg/day).
  • Clinical and laboratory data, including blood glucose levels and hypoglycemia events, were analyzed.

Main Results:

  • The higher initial insulin dose group (Group 1) demonstrated significantly lower median, minimum, and maximum blood glucose levels in the first 48 hours compared to the lower dose group (Group 2).
  • Group 1 showed a higher percentage of blood glucose readings within the target range (100-200 mg/dL) and fewer readings above 200 mg/dL.
  • The incidence of hypoglycemia (<70 mg/dL) was similar between the groups, with no severe hypoglycemia reported in either group.

Conclusions:

  • A higher initial dose of subcutaneous regular insulin (1.4-1.5 U/kg/day) following DKA resolution is associated with superior glycemic control in children and adolescents.
  • This intensified insulin regimen does not elevate the risk of hypoglycemia.
  • These findings support optimizing initial insulin dosing for improved post-DKA management.
Abstract

Keywords:
Type 1 diabetes mellituschildren adolescent.initial dosesregular insulin

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