Treatment

更新于 2026年10月31日 版权声明
3.Treatment

(1)Transfusion:3~4 L fluids in the first 6 hours(NS),3 L in the next 18 hours start with NS.alternate with RL(be careful in elderly/heart failure patients).

(2)Insulin:give 15~20 U Soluble Insulin by intravenous drip,insulin sliding scale(not ideal).

(3)Insulin pump:5 U/h,e.g.100 U Soluble insulin in 50 mL(=2 U/mL).

RBS>500 mg/d L→2.5 mL/h(=5 U/h).

RBS>400~499 mg/d L→2.0 mL/h(=4 U/h).

RBS>300~399 mg/d L→1.5 mL/h(=3 U/h).

RBS>200~299 mg/d L→0.5 mL/h(=1 U/h).

RBS>150~199 mg/d L→0.2 mL/h+D5%-drip.

RBS><150 mg/d L stop perfusion,switch to insulin acc.to rule thirds.(Be aware of signs of hypoglycemia.)

(4)Na-bicarbonte only in severe cases(can cause hypokalemia).

(5)Potassium according to the laboratory examination.

(6)Control infection,particularly using antibiotics in elderly TypeⅡ-patients(UTI).(https://www.daowen.com)

(7)If RBS<250 mg/d L and Ketones in DKA<++,try to use oral antidiabetic in HONK patients and put on lente/soluble(acc.to rule of thirds)in DKA.

Abbreviations

DKA(diabetic ketoacidosis):酮症酸中毒

HONK(hyperosmolar non-ketotic diabetic coma):高渗性非酮症糖尿病昏迷

FBC(full blood count):血常规检查

RL:林格氏

RBS:血糖值

ACC.TO:根据

UTI(urinary tract infection):尿道感

NS:生理盐水

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