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Weight‐based insulin dosing for acute hyperkalemia results in less hypoglycemia
Author(s) -
Wheeler Dauria T.,
Schafers Stephen J.,
Horwedel Tim A.,
Deal Eli N.,
Tobin Garry S.
Publication year - 2016
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2545
Subject(s) - medicine , hypoglycemia , hyperkalemia , dosing , insulin , anesthesia
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