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7 Diabetic ketoacidosis (DKA) is a frequent and potentially life-threatening complication of type 1 diabetes. Though preventable and despite advances in monitoring technologies, insulin therapeutics and insulin delivery systems, the rates of both community and hospital acquired DKA remain largely unchanged. Although mortality today is relatively
22 maj 2020 · This is a subcutaneous (SubQ) insulin protocol that replaces insulin drip needs for mild to moderate DKA. Procedures are adapted for COVID-related considerations of minimizing risk to staff while optimizing patient safety and health.
Transition to adult critical care insulin drip protocol, weaning insulin drip to off as able. h. Discuss conversion to home insulin therapy with rounding Physician.
DIABETIC KETOACIDOSIS – INITIAL MANAGEMENT GUIDE. DIAGNOSIS OF DKA BLOOD GLUCOSE(BG) > 11*- (glucose may be normal in a known diabetic) + ACIDOSIS - pH <7.3 or HCO3-<15mmol/l + KETONAEMIA – Bld Ketones> 3mmol/l.
The rationale for using insulin in DKA are as follows † Suppression of ketogenesis † Reduction of blood glucose † Correction of electrolyte imbalance This requires insulin to be given at an appropriate dose and we recommend fixed dose per kilogramme infusions, see page ****. Targets for reducing ketonaemia/glucose and raising bicarbonate:
Add Dextrose (D51⁄2NS or D5NS*) to IVF @ 150 – 250 mL/h to maintain serum glucose 150 – 200 mg/dL and continue insulin at same rate. Titrate insulin to a minimum 0.1 Units/kg/hr and glucose goal between 150 – 200 mg/dL until ketosis and anion gap resolves.
BOX 1: INTRAVENOUS INSULIN THERAPY AND PRESCRIPTION Weight/insulin dose reference Guide A Fixed Rate Intravenous Insulin Infusion (FRIII) calculated on 0.1 units/kg body weight is recommended (see Weight/insulin dose Reference Guide)
