How is insulin drip calculated for DKA?
Remember that insulin is dosed based on weight. E.g., In DKA, you give 0.1 U / Kg as IV bolus and then 0.1 U / Kg/hr IV continuous infusion. For example, for a 47kg patient, I rounded up to give 5 units /hr of continuous infusion. But one of DKA’s diagnostic criteria is a blood glucose of > 250.
How do you give insulin infusion for DKA?
Key DKA management points Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h. Measure bedside glucose every 1 hour to adjust the insulin infusion rate.
What insulin do you give in DKA?
Our results indicate that treatment of DKA with SC aspart insulin every 1 or 2 h is as safe and effective as the treatment with IV regular insulin. The rate of decline of blood glucose concentration and the mean duration of treatment until correction of ketoacidosis were similar among different treatment groups.
What is insulin algorithm?
(See Glucose Management Algorithm). Step 1: Start Basal insulin. Start basal insulin 10 units or 0.1-0.2 units/kg daily or divided BID. Titrate dose based on Fasting Plasma Glucose (FPG). Increase by 2-4 units or 10-15% every 3-4 days until FPG within target range, generally 80-130mg/dL (individualize).
What is insulin drip?
Intravenous insulin is only administered in a diabetic or other emergency; people with diabetes administer their daily insulin doses subcutaneously. Intravenous insulin therapy is a treatment procedure to manage high blood sugar (hyperglycemia) with intravenous infusion of insulin.
How do you calculate fluid deficit in DKA?
Calculations should be double checked before prescribing fluid and insulin. Fluid rate equals (2 x daily maintenance + deficit) ÷ 48.
What is an insulin drip used for?
Intravenous insulin therapy is a treatment procedure to manage high blood sugar (hyperglycemia) with intravenous infusion of insulin.
How do you calculate fluid in DKA?
Fluid rate equals (2 x daily maintenance + deficit) ÷ 48. Change to a potassium chloride containing solution once serum potassium <5mmol/L and patient has passed urine. Initially use 40mmol Potassium chloride in 1000mL fluid.
What is basal insulin example?
Types of Basal Insulin
- Intermediate-acting.
- NPH (Humulin N, Novolin N). This can start working as quickly as an hour or two.
- Long-acting.
- Detemir (Levemir) and glargine (Basaglar, Lantus). These take about 2 hours to get into your bloodstream.
- Ultra-long-acting.
- Degludec (Tresiba) and glargine u-300 (Toujeo).
How do you titrate insulin drip?
Insulin infusion may be titrated between 0 and 30 U/hr using these guidelines to rapidly (within 3 h) achieve and maintain blood glucose in the target range (125-175 mg/dL). Round insulin infusion to the nearest tenth of a unit (0.1 U) when necessary.
How does insulin drip work?
Intravenous insulin acts rapidly and lasts for a very short duration in the body. To maintain the desired glucose levels in the blood, insulin is infused continuously with appropriate dosage titrations depending on the blood sugar level.
What is insulin used for DKA?
Only short-acting insulin is used for correction of hyperglycemia . Subcutaneous absorption of insulin is reduced in DKA because of dehydration; therefore, using intravenous routes is preferable. SC use of the fast-acting insulin analog (lispro) has been tried in pediatric DKA (0.15 U/kg q2h).
When to stop insulin drip?
Discontinue insulin when: Bicarbonate level is ≥17mmol/L. Anion gap is normalized. And/or blood ketones are negative to small. Once the insulin drip is stopped, discontinue D10NS with additives if patient’s blood glucose is stable.
What is insulin titration?
Titration of insulin over time is critical to improving glycemic control and preventing diabetes-related complications. Insulin is secreted continuously by beta cells in a glucose-dependent manner throughout the day. It is also secreted in response to oral carbohydrate loads,…
