Insulin & Dextrose Infusion

Last updated 20.09.12

 

Definition

- IV infusion of short acting Insulin simultaneously w IV Dextrose

 

Indications

- When fasting Diabetics dependant on Insulin (DM1 +/- DM2)

-  Pre-operation

-  As Mx: Diverticulitis..

- Hyperkalaemia: for rapid reduction in serum K+

 

Procedure

- Infusion

-  10% Dextrose IV fluids 1L 12/24

-   Commenced when BSL <15.0 mmol/L or NBM

-  50 units Actrapid/Huminlin R Insulin in 50mls NS (1 unit/ml)

-   6-8 unit bolus initially

-   Infusion rate

-   2/3 normal daily total units

-   Divided by 24 for hourly rate

-   Ie: if 10, 10, 10 units = 30 units total per day

-  2/3 x 30 = 20 units

-  20/24 = 0.83 units/hour for infusion

-   Adjust infusion rate APP based on BSLs

-  BSLs every 1/24

-  When BSL 6-12 for 3/24 check 2/24

-  BSL >12: increase by 1 unit/hr until 6-12

-  BSL 4-6: decrease by 1 unit/hr until 6-12

-  BSL <4

-  3-4 & no S/S: halve infusion rate, BSL in 30min

-  <3 & no S/S: double Dextrose rate, BSL in 30min

-  Symptomatic hypoglycaemia: 25ml 50% Dextrose & double Dextrose rate, BSL 30min

-   Do not turn Insulin off, keep at least 0.5 units/hr

-   Regular urinary ketones

-  S/C Insulin given 30min prior to ceasing infusion

-  Returned to normal regime once eating normally w QID BSLs

- Bolus

-  Used for Hyperkalaemia

-  50% Dextrose 50mls (give before Insulin)

-  10 units Actrapid Insulin IV bolus

-  Effect within 30min to reduce K+

 

Complications

- Hypoglycaemia

 

 

References