To relate adverse events with glucose correction rates in diabetic ketoacidosis (DKA) using variable rate intravenous insulin-infusions (VRIII). Retrospective, observational study in adults with DKA who received insulin infusions between 2012 and 2017 at St Vincent's Hospital, Melbourne. Early correction of hyperglycaemia (<10 mmol/L) was evaluated for association with hypoglycaemia (<4.0 mmol/L), hypokalaemia (potassium <3.3 mmol/L) and clinical outcomes via regression analysis. The study involved 97 patients, with 93 % having type 1 diabetes. The mean age was 38 years, 47 % were women and 35 % were admitted to intensive care. Hypoglycaemia rates during 12 and 24 h of treatment were 6.2 % and 8.2 %, respectively with 58 % of patients recording their first BGL <10 mmol/L within 12 h and 88 % within 24 h. Ketone clearance time averaged at 15.6 h. Hyperglycaemia correction rates to <10 mmol/L were not different in those with/without hypoglycaemia at 12/24 h, in multivariate analysis including admission BGL. Hypokalaemia occurred in 40.2 % of patients and was associated with lower pH but not BGL correction rates. The VRIII protocol achieved early hyperglycaemia correction and ketoacidosis reversal with low hypoglycaemia risk. However, high hypokalaemia rates suggest the need for aggressive potassium replacement, especially in markedly acidotic patients.

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与可变速率胰岛素输注糖尿病酮症酸中毒方案相关的结果

使用可变速率静脉注射胰岛素 (VRIII) 将不良事件与糖尿病酮症酸中毒 (DKA) 的血糖校正率联系起来。对 2012 年至 2017 年间在墨尔本圣文森特医院接受胰岛素输注的 DKA 成人进行回顾性观察研究。通过回归分析评估早期纠正高血糖（<10 mmol/L）与低血糖（<4.0 mmol/L）、低钾血症（钾<3.3 mmol/L）和临床结果的关系。该研究涉及 97 名患者，其中 93% 患有 1 型糖尿病。平均年龄为 38 岁，47% 为女性，35% 入住重症监护室。治疗 12 小时和 24 小时期间的低血糖率分别为 6.2% 和 8.2%，其中 58% 的患者在 12 小时内首次记录 BGL <10 mmol/L，88% 的患者在 24 小时内记录首次 BGL <10 mmol/L。酮清除时间平均为 15.6 小时。在包括入院 BGL 在内的多变量分析中，12/24 小时有/无低血糖的高血糖校正率 <10 mmol/L 没有差异。40.2% 的患者发生低钾血症，并且与较低的 pH 值相关，但与 BGL 校正率无关。VRIII方案实现了早期高血糖纠正和酮症酸中毒逆转，且低血糖风险较低。然而，高低钾血症发生率表明需要积极补充钾，特别是对于明显酸中毒的患者。