The Journal of pediatrics
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The Journal of pediatrics · Oct 1976
Continuous low-dose infusion of insulin in the treatment of diabetic ketoacidosis in children.
Twelve diabetic children--eight in ketoacidosis, three with insulin refractory hyperglycemia, and one postoperative patient--were treated with continuous, low-dose, intravenous infusion of insulin. The eight ketoacidotic children with a mean serum glucose concentration on admission of 631 mg/dl and bicarbonate value of 6.8 mM/1 were given regular insulin, 0.1 U/kg, slowly by bolus injection followed by a sustaining infusion of 0.1 U/kg/hour. Plasma glucose concentration fell at a mean rate of 82 mg/dl/hour. ⋯ Mean plasma insulin in those children who had not previously received insulin was 55 muU/ml, well within the normal physiologic range. Growth hormone and serum triglyceride levels, low initially, rose with insulin therapy before returning to control values. Continuous low-dose insulin infusion is simple, safe, and effective, avoids confusion and empiricism, and appears to be the method of choice for the treatment of diabetic ketoacidosis or insulin resistance.