[Diabetic ketoacidosis in children. Effectivity of therapy with small doses of insulin applicated intravenously versus conventional therapy (author's transl)].

Abstract

Since 1972, the treatment of diabetic coma, ketoacidotic or hyperosmolar, with regular infusions of low doses of insulin, is a well-established form of therapy. Pediatricians all over the world apply this regimen regularly since 1975. In contrast to this there is the regime of intravenous or intramuscular application of high doses of insulin. To control the effectivity of these two methods, we compared two approximately identical groups of patients and analysed 17 different parameters. The patients of the low dose insulin infusion regimen needed less insulin, potassium and bicarbonate and reached earlier a bloodglucose level of 300 mg/dl. They also had a rapid and uneventful restoration of their electrolyte metabolism. Hypoglycaemia did not occur. There was no significant hypokalaemia or hypernatraemia. In contrast to this, the conventionally treated group showed much more complications. The hospital stay and the daily requirement of insulin was significantly higher. We believe that the low dose infusion regimen of insulin is a safe and easy therapeutic method. It surely is an alternative way for treating diabetic coma.