Saturday, March 14, 2015

Q: What is the general overlap time between IV insulin and SQ insulin at resolution of DKA


Answer: About 60 minutes (few recommends upto 2 hours)

Patients with known diabetes may be given insulin at the dosage they were receiving before the onset of DKA. In patients with newly diagnosed diabetes, an initial insulin dose of 0.6 unit/kg/day is usually sufficient. Overlapping of subcutaneous insulin and intravenous insulin infusion for 1- or 2-h avoid recurrence of hyperglycemia or ketoacidosis.

Importantly, if patients are not able to eat, intravenous insulin should be continued while an infusion of 5% dextrose in half-normal saline is given at a rate of 100–200 mL/h.

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