An Evaluation of Dosing Regimens for Insulin in Diabetic Ketoacidosis

Abstract

A review of the literature was performed to evaluate insulin dosing regimens used in the treatment of diabetic ketoacidosis.

High-dose insulin therapy was demonstrated to be effective in the largest number of patients, but carries the added risks of a high incidence of hypokalemia and hypoglycemia. Low-dose insulin regimens are effective for most patients, and these regimens produce a lower incidence of hypokalemia and hypoglycemia than do the high-dose therapies. Continuous intravenous infusion appears to be preferable to intermittent intramuscular or subcutaneous administration of insulin.

Low-dose insulin therapy is recommended unless the DKA patient presents with shock. Regardless of the dosing regimen or route of administration selected, careful patient monitoring and correction of electrolyte imbalances is most important in the prevention of any complications.