Evidence-based On-call

Diabetic ketoacidosis

Therapy

If glucose < 10 mmol/l but ketones are still raised, continue the insulin infusion with 5% or 10% glucose iv to maintain glucose 5 to 10 mmol/l. ^a

Why?

Patients with diabetic ketoacidosis who receive an extended insulin regimen have a more rapid fall in ketones than those on a conventional regimen (~16 hours difference) ^a