Monday May 10, 2010


Q: While starting treatment for DKA (Diabetes Ketoacidosis) how much time should be allowed between initiation of IVF (hydration) and Insulin infusion?



A: About one hour

Insulin should be started about an hour after intravenous fluid replacement is started to allow for checking potassium levels and because insulin may be more dangerous and less effective before some fluid replacement has been obtained. Danger of life-threatening hypokalemia due to aggressive insulin administration is possible, as well as there is no advantage in starting insulin prior to rehydration and evaluation of serum potassium levels.