1977 Volume 20 Issue 1 Pages 98-105
There have been several reports concerning the treatment of diabetic coma and ketoacidosis with continuous small-dose infusion of insulin. But none of them were supported by experimental observations. We have already confirmed the efficacy of small-dose insulin infusion therapy in depancreatized ketotic dogs. Based on these observations, 4 diabetic ketosis, 1 non-ketotic hyperosmolar coma and 1 diabetic coma were treated with continuous small-dose insulin infusion. In each case, 0.5%-1% albumin or 0.7% gelatin was added into insulin solutions to prevent the adsorption of insulin on the glassware during the treatment.
Results of the treatments were very satisfactory and all the patients recovered safely within 10hours. Means (±S. E. M.) of pretreatment blood sugar, rate of insulin infusion and rate of decrease in blood sugar level during treatment were 762±127 mg/dl, 8.8±3.3 U/hr and 115±21mg/dl·Ehr, respectively. Plasma 3-hydroxybutyrate levels decreased rapidly and returned to normal levels within 3 hours. Hypoglycemia was not observed in the course of the treatment. As far as the serum potassium levels were concerned, severe hypokalemia was not observed. But the serum potassium decreased significantly as compared to the pretreatment levels in each case. From these results, the necessity of potassium supplementation is suggested in the cases showing low pretreatment levels of potassium.
Thus, it is confirmed that “small-dose insulin infusion therapy” for the diabetic coma and ketoacidosis is as effective as the conventional large-dose insulin therapy.
