Weight-based Insulin in Hyperkalemia Results in Less Hypoglycemia

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Less hypoglycemia for patients weighing less than 95 kg, with no impact on potassium lowering.
Less hypoglycemia for patients weighing less than 95 kg, with no impact on potassium lowering.

(HealthDay News) -- Weight-based insulin dosing is associated with less hypoglycemia than standard dosing for patients with acute hyperkalemia weighing less than 95 kg, according to a study published online in the Journal of Hospital Medicine.

Dauria T. Wheeler, PharmD, from the St. Louis College of Pharmacy, and colleagues conducted a single-center, retrospective study to compare the effects on hypoglycemia of weight-based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) versus standard flat doses of 10 U. Charts for 132 patients weighing less than 95 kg with acute hyperkalemia were randomly selected.

The researchers observed a reduction in hypoglycemic events from 27.3% in the 10-U group to 12.1% in the weight-based group (P = 0.05). There was a reduction in the number of affected patients, with 19.7 and 10.6%, respectively, in the 10-U and weight-based groups (P = 0.22). Similar potassium-lowering effects were seen between the groups. The risk of hypoglycemia was increased for female patients and for those with baseline glucose values <140 mg/dL.

"Weight-based insulin dosing (0.1 U/kg) for acute hyperkalemia therapy resulted in less hypoglycemia without impacting potassium lowering," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Source

  1. Wheeler DA, Schafers SJ, Horwedelet TA, et al. Weight-based Insulin Dosing for Acute Hyperkalemia Results in Less Hypoglycemia. Journal of Hospital Medicine. doi:10.1002/jhm.2545. 
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