Hypoglycaemia incidence with a simple, low-dose insulin protocol for adult diabetic ketoacidosis

Abstract

Objective The objective of this study is to validate the glycaemic safety of a simple insulin protocol using weight-based insulin rates adapted from American guidance for the management of adult diabetic ketoacidosis. Methods Measures of hypoglycaemia were retrospectively assessed in a single cohort of inpatient adults. The primary outcome was incidence of hypoglycaemia during insulin infusion. Key findings Hypoglycaemia during infusion occurred in 6/81 patients (7% [95% CI 3–16%]). Five of these occurrences were associated with protocol nonadherence. Conclusions The glycaemic safety of a novel, variable-rate insulin protocol directly incorporating weight-based infusion rates is supported by this single-centre study.