Can you give subcutaneous insulin for DKA?
CONCLUSIONS—Our results indicate that the use of subcutaneous insulin aspart every 1 or 2 h represents a safe and effective alternative to the use of intravenous regular insulin in the management of patients with uncomplicated DKA.
When should I change to SUBQ insulin DKA?
Insulin therapy after resolution of DKA When the patient is able to tolerate oral intake and DKA is resolved, transition to subcutaneous insulin must be initiated. It is common to see transition from intravenous to subcutaneous insulin using sliding scale insulin only.
Can you go into DKA with an insulin pump?
Your Risk of DKA People who use an insulin pump are at greater risk of DKA than people who give themselves injections. This is because pumps do not use long- acting insulin. Pumps use only rapid-acting (short-acting) insulin that starts working in 10 to 15 minutes and lasts 4 to 5 hours in most people.
What is the protocol for DKA?
A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.
How do you switch from IV insulin to subcutaneous insulin?
As described above for patients who are NPO, it is recommended that the subcutaneous long-acting insulin be given at least 1 h (but preferably 2-4 h) before stopping the IV insulin [6,18]. If the patient will be eating, an order for rapid-acting insulin may be added to cover prandial requirements.
Why use short-acting insulin for DKA?
Only short-acting insulin is used for correction of hyperglycemia in DKA. The optimal rate of glucose decline is 100 mg/dL/h. The blood glucose level should not be allowed to fall lower than 200 mg/dL during the first 4-5 hours of treatment.
What is the difference in duration between regular insulin subcutaneous and regular insulin IV?
Sub- cutaneous administration of insulin analogs (14) has an on- set of action within 10 to 20 minutes, a peak within 30 to 90 minutes, and a duration of action of approximately 3 to 4 hours, which is shorter than with regular insulin that has an onset of action of 1 to 2 hours and a half-life of about 4 hours (1,15).
What do you do with insulin pump in DKA?
Give 1.5 times the usual correction dose using insulin syringe or pen. Once you have given the insulin by pen or syringe, change the pump site. Continue testing for ketones and giving insulin as above every 2 hours until ketones are negative. Call the Diabetes Centre if ketones do not improve.
Why the risk of DKA is higher when using an insulin pump?
People on an insulin pump are at a higher risk for DKA because they are not using long acting insulin. DKA can develop in as few as 2- 4 hours if the insulin infusion is interrupted or boluses are missed.
What is the most important treatment for DKA?
Proper management of DKA includes prompt initiation of IV fluids, insulin therapy, electrolytes replacement and recognition and treatment of precipitating causes. Close monitoring of patient’s condition by regular clinical and laboratory data and the use of management protocols help ensure better outcomes.
How do you bridge a DKA patient?
You just need to give them a pre-meal bolus of insulin to cover their meal and continue the other drips as you would in a patient who hadn’t eaten. The food will raise their blood sugars. Instead of changing the insulin drip, it’s best to give them the pre-meal insulin to cover this rise in sugar from the food.
What is the best insulin for DKA?
CONCLUSIONS. Regular and glulisine insulin are equally effective during the acute treatment of DKA. A transition to subcutaneous glargine and glulisine after resolution of DKA resulted in similar glycemic control but in a lower rate of hypoglycemia than with NPH and regular insulin.
Why is the risk of DKA high when using an insulin pump?
What are the three criteria for DKA?
Three key features of diabetic acidosis are hyperglycemia, ketosis, and acidosis. The conditions that cause these metabolic abnormalities overlap.
How do you transition to subcutaneous insulin?
What is insulin used for DKA?
Replacing fluids you lost through frequent urination and to help dilute excess sugar in your blood.
Why do we administer insulin to a DKA patient?
Illness,infection,and dehydration can cause the production of large quantities of stress hormones,which counteract insulin.
Why are DKA patients NPO?
– Diabetes Complications in Dogs and Cats: Diabetes Ketoacidosis (DKA) – Diabetic Ketoacidosis – Diabetic Ketoacidosis Increases Risk of Acute Renal Failure in Pediatric Patients with Type 1 Diabetes
When to start insulin GTT ICU?
□ Start insulin therapy (after fluids started and only if K >3.3 mmol/L) □ Adjust insulin infusion rate as needed □ If DKA resolved, stop intravenous insulin and start subcutaneous insulin □ Consult diabetes team □ Maintain K at 3.3–5.3 mmol/L range □ Consult diabetes educator Open in a separate window