Related Experiment Video

Updated: Sep 3, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.9K

Efficacy and Safety of Low Dose Insulin Infusion against Standard Dose Insulin Infusion in Children with Diabetic

Diganta Saikia1, Medha Mittal1, Chapala Kanakaraju1

  • 1Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Delhi, India.

Indian Journal of Endocrinology and Metabolism
|July 25, 2022
PubMed

Insights

Low dose insulin infusion is as effective and safe as standard dose for treating diabetic ketoacidosis in children. This approach offers comparable outcomes in acidosis resolution and blood glucose reduction without increasing risks.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Critical Care Medicine

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of diabetes in children.
  • Standard insulin infusion protocols for DKA are well-established but can be associated with complications.
  • Optimizing insulin dosing in pediatric DKA is crucial for effective and safe management.

Purpose of the Study:

  • To compare the efficacy and safety of a low-dose insulin infusion (0.05 U/kg/h) versus a standard-dose insulin infusion (0.1 U/kg/h) in pediatric patients with DKA.
  • To evaluate the impact of different insulin doses on the resolution of acidosis and glycemic control.
  • To assess secondary outcomes including hypoglycemia, hypokalemia, and treatment failure rates.

Main Methods:

  • An open-label, randomized controlled trial involving 30 children under 12 years with DKA.
  • Participants were randomized to receive either low-dose (0.05 U/kg/h) or standard-dose (0.1 U/kg/h) insulin infusion.
  • Primary outcome was time to acidosis resolution; secondary outcomes included time to glucose normalization, hypoglycemia, hypokalemia, and treatment failure.

Main Results:

  • Acidosis resolution time was similar between groups (27.0 ± 6.1 hours low dose vs. 23.4 ± 7.3 hours standard dose, P=0.16).
  • Time to achieve blood glucose of 250 mg/dl was also comparable (13.0 ± 5.9 hours low dose vs. 11.6 ± 6.0 hours standard dose, P=0.52).
  • Lower, though not statistically significant, rates of hypoglycemia and hypokalemia were observed in the low-dose group. No treatment failures occurred.

Conclusions:

  • Low-dose insulin infusion (0.05 U/kg/h) is as effective as standard-dose insulin infusion (0.1 U/kg/h) for treating diabetic ketoacidosis in children.
  • The low-dose regimen appears equally safe, with a trend towards fewer complications like hypoglycemia and hypokalemia.
  • This suggests that reduced insulin infusion rates can be a viable and safe option for managing pediatric DKA.
Abstract

Keywords:
Acidosischildrenregular insulin

More Related Videos

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health06:13

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health

Published on: December 1, 2023

1.2K
Pancreatic Duct Infusion: An Effective and Selective Method of Drug and Viral Delivery06:03

Pancreatic Duct Infusion: An Effective and Selective Method of Drug and Viral Delivery

Published on: September 30, 2021

5.0K

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
240
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
262
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
320
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
243
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
3.1K
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are...
1.4K