Low dose (0.05 units/kg/h) is comparable with standard dose (0.1 units/kg/h) intravenous insulin infusion for the initial treatment of diabetic ketoacidosis in children with type 1 diabetes-an observational study
| Autor: | R, Puttha, D, Cooke, A, Subbarayan, E, Odeka, I, Ariyawansa, M, Bone, I, Doughty, L, Patel, R, Amin |
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| Rok vydání: | 2010 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Diabetic ketoacidosis Endocrinology Diabetes and Metabolism Diabetic Ketoacidosis law.invention Randomized controlled trial law Diabetes mellitus Internal Medicine medicine Humans Hypoglycemic Agents Insulin Child Infusions Intravenous Acidosis Type 1 diabetes business.industry Glasgow Coma Scale medicine.disease Confidence interval Surgery Bicarbonates Diabetes Mellitus Type 1 Anesthesia Pediatrics Perinatology and Child Health Female Observational study medicine.symptom business |
| Zdroj: | Pediatric Diabetes. 11:12-17 |
| ISSN: | 1399-5448 1399-543X |
| DOI: | 10.1111/j.1399-5448.2009.00536.x |
| Popis: | Puttha R, Cooke D, Subbarayan A, Odeka E, Ariyawansa I, Bone M, Doughty I, Patel L, Amin R. Low dose (0.05 units/kg/h) is comparable with standard dose (0.1 units/kg/h) intravenous insulin infusion for the initial treatment of diabetic ketoacidosis in children with type 1 diabetes—an observational study Objective: To compare low dose (0.05 units/kg/h) with standard dose (0.1 units/kg/h) intravenous insulin infusion for the treatment of diabetic ketoacidosis (DKA) in children with type 1 diabetes. Study design: Data from five paediatric centres were compared in children who received 0.05 (41 episodes) or 0.1 units/kg/h (52 episodes). Results: In the low vs. standard dose group, at 6 h following admission, the fall in blood glucose levels [11.3 (95% confidence interval 8.6 to 13.9) vs. 11.8 (8.4 to 15.2) mmol/L, p = 0.86] and rise in pH [0.13 (0.09 to 0.18) vs. 0.11 (0.07 to 0.15), p = 0.78] were similar. These changes were comparable between doses in relation to: severity of initial acidosis, children newly diagnosed with diabetes or aged less than 5 years. After adjustment for other clinical and biochemical covariates, insulin dose was unrelated to the change in pH and blood glucose levels at 6 h following admission. Comparisons of safety data, particularly in relation to abnormal Glasgow Coma Score, were inconclusive. Conclusion: In this observational study, low dose was as effective as standard dose intravenous insulin infusion in the initial treatment (less than 6 h) of DKA in children with type 1 diabetes. A randomised controlled trial is required to show true equivalence between doses and to evaluate potential safety benefits. |
| Databáze: | OpenAIRE |
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