ABBAS E. KITABCHI, Ph.D., M.D.; VENTACHALAM AYYAGARI, M.D.; SONIA M. O. GUERRA, M.D.; MEDICAL HOUSE STAFF
The effect of low-dose intramuscular insulin therapy was compared with that of high-dose insulin therapy by intravenous and subcutaneous routes in 48 patients with diabetic ketoacidosis. A simplified protocol was devised to compare efficacy of the two methods of therapy in a randomized manner. Plasma glucose dropped to less than 250 mg/dl in the low-dose group in 6.7 ± 0.8 h and in the high-dose group in 4.5 ± 0.8 h (P = not significant). The amount of insulin necessary to lower plasma glucose to 250 mg/dl was 263 ± 45 U in the high-dose group and 46 ± 5 U in the low-dose group. Twenty five percent in the high-dose group and none in the low-dose group developed hypoglycemia. Other biochemical and clinical variables in the two groups were comparable. No treatment complications were noted in the low-dose group. Our studies suggest that low-dose intramuscular insulin therapy is simple and as effective as high-dose therapy in the treatment of diabetic ketoacidosis without the risk of hypoglycemia and with a diminished incidence of hypokalemia. Furthermore, the favorable response of these patients to low-dose insulin therapy suggests the absence of insulin resistance in diabetic ketoacidosis.
KITABCHI AE, AYYAGARI V, GUERRA SMO, MEDICAL HOUSE STAFF. The Efficacy of Low-Dose Versus Conventional Therapy of Insulin for Treatment of Diabetic Ketoacidosis. Ann Intern Med. ;84:633–638. doi: 10.7326/0003-4819-84-6-633
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Published: Ann Intern Med. 1976;84(6):633-638.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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