Determination of insulin requirements: excessive insulin dosages common in type 1 diabetes mellitus.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
J AkhterW C Duckworth

Abstract

To report our experience of determining insulin requirements for initiating continuous subcutaneous insulin infusion (CSII) pump therapy, using an algorithm for intravenous administration of insulin, in patients with poorly controlled diabetes. We describe assessment of insulin requirements and analyze data from 27 consecutive admissions. All patients had type 1 diabetes mellitus and were being converted to CSII pump therapy. Twenty-four-hour intravenous insulin requirements were used to initiate CSII pump therapy, and further dose adjustments were undertaken, to optimize glycemic control. Basal, bolus, and total daily insulin requirements were calculated before, during, and 3 months after conversion to CSII therapy. At entry, the mean glycohemoglobin was 11.2% (normal, 5.0 to 8.0%), and the mean daily insulin dose were 45.8 U (0.59 U/kg). Calculated daily insulin requirements using an algorithm for intravenously administered insulin were 37.3 U (0.50 U/kg). At 3 months, mean daily insulin requirements had increased to 39.2 U (0.52 U/kg), and glycohemoglobin improved to 9.4%. Most patients (78%) remained on insulin doses within 10% of the calculated requirements. All patients who were receiving more than 0.6 U/kg daily before a...Continue Reading

References

Nov 1, 1991·The American Journal of Clinical Nutrition·J W AndersonR J Whitley
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Jun 1, 1994·Postgraduate Medicine·Nancy J V Bohannon

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Citations

Aug 21, 2013·Hospital Practice·Carlos E Mendez, Guillermo Umpierrez
Oct 5, 2001·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·A A RizviM Chakraborty

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