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Michael S. Kappy, MD, PhD; Elmer S. Lightner, MD

Am J Dis Child. 1979;133(5):523-525.

Abstract
• Continuous slow intravenous infusion of insulin was used in 52 episodes of diabetic ketoacidosis. No complications of therapy, ie, hypoglycemia, induced hypokalemia, insulin resistance, or cerebral edema, were encountered. Potassium phosphate was given to 47 of the 52 patients. Sodium bicarbonate was administered to only one patient. The hyperglycemia frequently resolved more rapidly than the systemic acidosis; this was managed by adding glucose to the intravenous fluids when the blood sugar concentration decreased to approximately 250 mg\dL; insulin infusion, however, was continued until the acidosis was corrected (venous standard bicarbonate > 14 mg/L). We have found this method of treatment to be safe and simple to administer, and we believe it is the preferred treatment of patients with diabetic ketoacidosis.

(Am J Dis Child 133:523-525, 1979)

Author Affiliations
From the Departments of Family and Community Medicine (Dr Kappy) and Pediatrics (Dr Lightner), University of Arizona Health Sciences Center, Tucson. Dr Kappy is now with the Division of Pediatric Endocrinology, The Johns Hopkins Hospital, Baltimore.

Footnotes
Reprint requests to Endocrine Division, Department of Pediatrics, CMSC 3-110, The Johns Hopkins Hospital, Baltimore, MD 21205 (Dr Kappy).

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