Wednesday, August 10, 2016

Q: What are the good indicators in Diabetic Ketoacidosis (DKA) to transit from IV insulin infusion to subcutaneous insulin injections? 


Answer: According to American Diabetes Association (ADA) guidelines for DKA,  IV insulin can be tapered and subcutaneous insulin doses can be scheduled to start when the blood glucose is less than 200 mg/dL and 2 of the following 3 goals are met
  • Serum anion gap less than 12
  • Serum bicarbonate more than or equal to 15
  • Venous PH more than 7.30


References:

Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care 2009; 32:1335.

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