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首页> 外文期刊>Diabetes care >Is a priming dose of insulin necessary in a low-dose insulin protocol for the treatment of diabetic ketoacidosis?
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Is a priming dose of insulin necessary in a low-dose insulin protocol for the treatment of diabetic ketoacidosis?

机译：在小剂量胰岛素治疗方案中治疗糖尿病酮症酸中毒需要胰岛素的启动剂量吗？

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OBJECTIVE: The purpose of this study was to assess the efficacy of an insulin priming dose with a continuous insulin infusion versus two continuous infusions without a priming dose. RESEARCH DESIGN AND METHODS: This prospective randomized protocol used three insulin therapy methods: 1) load group using a priming dose of 0.07 units of regular insulin per kg body weight followed by a dose of 0.07 unit x kg(-1) x h(-1) i.v. in 12 patients with diabetic ketoacidosis (DKA); 2) no load group using an infusion of regular insulin of 0.07 unit . kg body weight(-1) x h(-1) without a loading dose in 12 patients with DKA, and 3) twice no load group using an infusion of regular insulin of 0.14 x kg(-1) x h(-1) without a loading dose in 13 patients with DKA. Outcome was based on the effects of insulin therapy on biochemical and hormonal changes during treatment and recovery of DKA. RESULTS: The load group reached a peak in free insulin value (460 microU/ml) within 5 min and plateaued at 88 microU/ml in 60 min. The twice no load group reached a peak (200 microU/ml) at 45 min. The no load group reached a peak (60 microU/ml) in 60-120 min. Five patients in the no load group required supplemental insulin doses to decrease initial glucose levels by 10%; patients in the twice no load and load groups did not. Except for these differences, times to reach glucose or=7.3, and HCO(3)(-) >or=15 mEq/l did not differ significantly among the three groups. CONCLUSIONS: A priming dose in low-dose insulin therapy in patients with DKA is unnecessary if an adequate dose of regular insulin of 0.14 unit x kg body weight(-1) x h(-1) (about 10 units/h in a 70-kg patient) is given.
机译：目的：本研究的目的是评估连续胰岛素输注与不连续胰岛素输注两次连续输注的胰岛素灌注剂量的疗效。研究设计和方法：该前瞻性随机方案使用了三种胰岛素治疗方法：1）负荷组，使用0.07单位常规胰岛素每千克体重的引发剂量，然后再使用0.07单位x kg（-1）xh（-1）的剂量）iv在12例糖尿病酮症酸中毒（DKA）中; 2）无负荷组使用0.07单位的常规胰岛素输注。 12例DKA患者无负荷剂量时的kg体重（-1）xh（-1）和3）无负荷组的两次（使用0.14 x kg（-1）xh（-1）的常规胰岛素输注） 13例DKA患者的最大负荷剂量。结果是基于胰岛素治疗对DKA治疗和恢复期间生化和激素变化的影响。结果：负荷组在5分钟内达到游离胰岛素值的峰值（460 microU / ml），并在60分钟内达到稳定的88 microU / ml。两次无负荷组在45分钟时达到峰值（200 microU / ml）。空载组在60-120分钟内达到峰值（60 microU / ml）。空载组中的五名患者需要补充胰岛素剂量，以将初始葡萄糖水平降低10％。两次无负荷的患者，负荷组则没有。除这些差异外，三组之间达到葡萄糖≤250mg / dl，pH≤7.3和HCO（3）（-）≥15mEq / l的时间无显着差异。结论：如果足量的0.14单位x千克体重（-1）xh（-1）的常规胰岛素（在70-公斤病人）。

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