How do you calculate insulin infusion in DKA?

A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.

What type of insulin is given in DKA?

Insulin lispro (Humalog)

How is TDD insulin calculated?

Basal/background insulin dose:

  1. Assume you weigh 160 pounds.
  2. Your total daily insulin dose (TDI) = 160 lbs ÷ 4 = 40 units.

How do you start insulin based on weight?

Use the patient’s weight, body habitus or diabetic status. 0.4 units/kg/day for a patient at normal weight; 0.5 units/kg/day for overweight patients; and. 0.6 units/kg/day or more for patients who are obese, on high-dose steroids or insulin-resistant.

How much insulin do you give for ketoacidosis?

Treatment of DKA with intravenous insulin Insulin treatment has evolved from the use of high-dose insulin, with doses up to 100 U/h by various routes of administration, to lower doses in the range of 5–10 U/h. We recommend an initial bolus of regular insulin of 0.1 U/kg followed by continuous insulin infusion.

Which insulin is best for ketoacidosis?

Metabolic acidosis Insulin is used to stop ketoacid production; intravenous fluid alone has no impact on parameters of ketoacidosis (52). Short-acting insulin (0.1 units/kg/h) is recommended (53–55).

Why is regular insulin given in DKA?

Insulin administration is essential in DKA treatment because it promotes glucose utilization by peripheral tissues, diminishes glycogenolysis and gluconeogenesis, and suppresses ketogenesis.

What is the 450 rule?

Alternatively, the insulin-to-carbohydrate ratio (ICR) may be determined by the “450 rule.” To determine the ICR, divide 450 by the child’s total daily dose of insulin (TDD). For example, for a child with a TDD of 36 units, the ICR would be 450/36 = 12.5, or 1 unit per 12 g of carbohydrate.

How is ICR and ISF calculated?

ICR was calculated by dividing carbohydrate grams by insulin units. Insulin sensitivity factor (ISF) was defined by the 100 rule (100 divided by total daily insulin dose [TDD]).