Endocrinology Book

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Hourly Subcutaneous Insulin Lispro

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  1. See Also
    1. Insulin Infusion
    2. Diabetic Ketoacidosis
  2. Indications
    1. Diabetic Ketoacidosis in adults
  3. Protocol using subcutaneous Insulin Lispro
    1. Initial dose: 0.3 units/kg
    2. Next: 0.1 units/kg/hour until hyperglycemia corrects
    3. Next: 0.05 units/kg/hour until DKA resolves
    4. Coadminister fluids as per Diabetic Ketoacidosis
    5. Discontinue hourly dosing when glucose 150-200
  4. Precautions
    1. Correct Hypokalemia prior to Insulin Dosing
    2. Fluid administration is central to DKA treatment
  5. Monitoring
    1. Blood Glucose every 30 minutes to 1 hour
  6. Advantage over Insulin Infusion
    1. May be monitored on regular medical ward (non-ICU)
    2. Reduced cost by 39% compared with infusion
  7. Safety and efficacy
    1. As effective and safe as Insulin Infusion
  8. References
    1. Umpierrez (2004) Am J Med 117:291

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