ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Very Low Dose Insulin Treatment In Diabetic Ketoacidosis
Yusuf ÖZKAN*, Emir DÖNDER**
* Yrd.Doç., Dr. Fırat Üniversitesi Tıp Fakültesi İç Hastalıkları AD,**Prof.Dr., Fırat Üniversitesi Tıp Fakültesi İç Hastalıkları AD, ELAZIĞ
Objectives: In recent years, it has been reported that very low dose insulin application is an effective and safe way in treatment of patients with diabetic ketoacidosis. In the present study, we aimed to examine the effects of very low dose insulin on treatment of diabetic ketoacidosis.
Material and Methods: The patients whose blood glucose level over 300 mg/dl, blood pH below 7.30 and blood acetone positive were included in this study. At the beginning of treatment, 10 U of basal insulin was given as bolus, and then 1 U/h insulin was applied as infusion. The aim of continuous insulin application was to reduce blood glucose level 50 mg/dl per hour. When the blood glucose level was not decreased to that expected level, the insulin dose was increased. In contrast, 5% dextrose was given when the rate of decrease in blood glucose level above 100 mg/dl.
Results: Totally 23 patients with diabetic ketoacidosis (13 type 1 diabetes mellitus and 10 type 2 diabetes mellitus) were included in this study. At the beginning of the treatment, the average blood glucose and pH were 472100 mg/dl (ranged between 323-640 mg/dl) and 7.170.14 (ranged between 6.88-7.30), respectively. Twelve hours after beginning of treatment, the average blood glucose level was decreased to 22819 mg/dl (ranged between 117-420 mg/dl) and blood pH was increased to 7.350.20 (ranged between 6.96-7.45). The average insulin infusion that reduced blood glucose 50 mg/dl per hour was applied for 1st, 2nd, 4th, 8th and 12th hours as 1 U, 1.7 U (1-3 U), 2.7 U (1-4 U), 3.8 U (1-10 U) and 4.4 U (2-17 U), respectively. All patients had no serious complication during this therapy. The patients stayed in intensive care unit approximately 16 hours (ranged between 4-72 hours).
Conclusion: The very low dose insulin therapy successfully treated our 23 patients with diabetic ketoacidosis. The result of present study suggests that very low dose insulin can be used with safely in patients with diabetic ketoacidosis.Keywords: Diabetic ketoacidosis, InsulinTurkiye Klinikleri J Med Sci 2003, 23:398-402
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