Lindsay R, Bolte R G
Department of Pediatrics, University of Utah Medical Center, Salt Lake City 84103.
Pediatr Emerg Care. 1989 Jun;5(2):77-9. doi: 10.1097/00006565-198906000-00001.
The use of an initial bolus of insulin prior to the initiation of low-dose insulin infusion therapy was evaluated in 56 episodes of diabetic ketoacidosis (DKA) in 38 children. The cases were randomly assigned to a group that received a bolus of insulin (n = 24) and to a group that did not (n = 32). After the first hour of insulin therapy, the decline in serum glucose level and the changes in serum osmolality were statistically similar in the two groups, regardless of the degree of acidosis. The time required to reach a serum glucose level of less than 250 mg/dl and the total duration of insulin infusion likewise were similar in the two groups. The use of a bolus of insulin at the onset of treatment for DKA appears unnecessary.
在38名儿童的56例糖尿病酮症酸中毒（DKA）病例中，评估了在低剂量胰岛素输注治疗开始前使用初始胰岛素推注的情况。这些病例被随机分为接受胰岛素推注的组（n = 24）和未接受胰岛素推注的组（n = 32）。胰岛素治疗第一小时后，两组的血糖水平下降和血清渗透压变化在统计学上相似，无论酸中毒程度如何。两组达到血糖水平低于250 mg/dl所需的时间以及胰岛素输注的总时长同样相似。在DKA治疗开始时使用胰岛素推注似乎没有必要。
