Weight‐based insulin dosing for acute hyperkalemia results in less hypoglycemia. Issue 5 (13th January 2016)

• Record Type: Journal Article
• Authors: Wheeler, Dauria T.; Schafers, Stephen J.; Horwedel, Tim A.; Deal, Eli N.; Tobin, Garry S.
• Is Part Of: Journal of hospital medicine. Volume 11:Issue 5(2016)
• Page Start: 355
• Page End: 357
• Publication Date: 2016-01-13
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2545
• Languages: English
• ISSNs: 1553-5592

Abstract

Abstract : Hyperkalemia treatment with intravenous insulin has been associated with hypoglycemia. This single‐center, retrospective study compared the effects on hypoglycemia between weight‐based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) compared to standard flat doses of 10 U among patients weighing less than 95 kg. Of the 132 charts randomly selected for review, hypoglycemic events (blood glucose <70 mg/dL) were reduced from 27.3% in the 10‐U group to 12.1% in the weight‐based group ( P = 0.05). The number of affected patients was reduced with 19.7% in the 10‐U group and 10.6% in the weight‐based group ( P = 0.22). The potassium‐lowering effects of these 2 strategies were similar between groups. Female patients and those with baseline glucose values <140 mg/dL were at increased risk for hypoglycemia. Weight‐based insulin dosing (0.1 U/kg) for acute hyperkalemia therapy resulted in less hypoglycemia without impacting potassium lowering. Journal of Hospital Medicine 2016;11:355–357. © 2016 Society of Hospital Medicine