Two groups of children with severe diabetic ketoacidosis were treated with 2 different insulin regimens: the first with conventional intermittent intramuscular insulin injections (0.5-1.0 U/kg/3-4 hrs), the second, with continuous low-dose insulin infusion (0.05-0.1 U/kg/hr). Therapeutic effects were compared. Compared to the conventional regimen, low-dose insulin infusion showed several advantages: 1) better control of blood glucose level, 2) no risk of hypoglycemia and hypokaliemia, 3) rapid decrease of urinary ketone bodies and 4) gradual acidosis correction. When associated with a proper replacement of fluids and electrolytes, low-dose insulin infusion appeared to be a simple and effective regimen in the treatment of children with diabetic ketoacidosis.
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