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  • Title: [Continuous perfusion of insulin in the treatment of acidoketotic coma in children].
    Author: Debbabi A, Ben Ghachem K, Dougui N, Lakhoua R, Jedidi H.
    Journal: Pediatrie; 1983 Sep; 38(6):379-86. PubMed ID: 6420770.
    Abstract:
    Ketoacidosis is still a frequent complication as far as our diabetic patients are concerned. The insulin regimen during this acute diabetic ketoacidosis was, until October 1981, administered at the start, half intravenously and half intramuscularly, then discontinuously every four hours, subcutaneously, according to the rate of glucose and acetoacetate. Since then, a new method has been used for the treatment of diabetic ketoacidosis providing a continuous perfusion without pumps, of insulin, glucose and electrolytes. The authors describe their experience, using this technique on ten children admitted to hospital because of severe diabetic ketoacidosis. A certain number of parameters and the evolution were studied. The glycemia graph shows a more harmonious and regular normalisation, urinary ketosis disappears within 8 and 24 hours (with an average of 16,22 h). The next step that consists in administering mixed insulin is taken between the 16th and 48th hours (with an average of 25,42 h). Two hypoglycemia have been reported contrary to the statements of other authors. Furthermore, these parameters were compared to those of 10 children submitted to the classical regimen. The authors conclude that a continuous perfusion presents a better method with approximately similar results, and its use is much simpler both for the patient and for the staff.
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