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Insulin infusion for diabetic children.

J Boulton, J Penfold

    The Medical Journal of Australia
    |October 31, 1981
    PubMed
    Summary

    Low-dose insulin infusion effectively manages diabetic children, including those with ketoacidosis and insulin resistance. This flexible approach aids in transitioning patients to subcutaneous insulin and provides predictable blood glucose control during surgery.

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    Area of Science:

    • Pediatric Endocrinology
    • Metabolic Disorders
    • Diabetes Management

    Background:

    • Diabetic ketoacidosis and insulin-refractory hyperglycemia present significant management challenges in children.
    • Current treatment protocols may require optimization for flexibility and efficacy in pediatric diabetes care.
    • Surgical procedures in diabetic children necessitate precise glycemic control.

    Purpose of the Study:

    • To evaluate the efficacy and safety of low-dose insulin infusion in managing pediatric diabetes.
    • To explore the utility of continuous insulin infusion in reversing diabetic ketoacidosis and insulin resistance.
    • To assess the role of low-dose insulin infusion in perioperative glycemic control for diabetic children.

    Main Methods:

    • A cohort of 10 diabetic children (aged 3.5-16.7 years) with ketoacidosis, insulin resistance, or undergoing surgery were treated with low-dose insulin infusion.
    • Infusion rates were adjusted based on clinical condition, with a mean infusion rate of 2.9 units/h for ketotic subjects and 2.6 units/h for stabilization.
    • Mean infusion duration was 33 hours, with an overall mean rate of 0.074 units/kg/h.

    Main Results:

    • Successful management was achieved in all 10 pediatric patients.
    • The technique facilitated a smooth transition to subcutaneous insulin regimens after initial correction.
    • Low-dose insulin infusion proved effective in breaking insulin-refractoriness and reversing ketoacidosis.
    • Predictable blood glucose control was observed during major surgery.

    Conclusions:

    • Low-dose insulin infusion offers a flexible and effective strategy for managing complex diabetes cases in children.
    • This method provides a valuable tool for reversing diabetic ketoacidosis and overcoming insulin resistance.
    • Continuous insulin infusion enhances perioperative glycemic management in pediatric surgical patients.

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