Treatment of diabetic coma with low-dose hourly intramuscular insulin

Ten diabetics with severe hyperglycaemia were treated with hourly low-dose intramuscular insulin injections. Five patients were keto-acidotic with a mean initial plasma glucose of 842 mg/100 ml and 5 were non-ketotic with a mean initial plasma glucose of 1 223 mg/100 ml. In every case there was an approximately linear and predictable lowering of plasma glucose, the average rate being 79 mg/100 ml/h in the ketotic group and 132 mg/100 ml/h in the non-ketotic group. Results closely paralleled those reported with continuous low-dose infusion techniques and this study supports the view of Alberti et al. that hourly intramuscular insulin therapy is a simple and reliable alternative to infusion therapy where necessary equipment is unavailable.