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Conventional dose still better than reduced dose insulin for hyperkalaemia

02 Jun 2020
Reduced dependence on insulin injections may make patients more inclined to comply with treatment and reduce adverse effects of the injections such as local lipomas or scars.

A recent study has shown that conventional dose insulin remains more effective than reduced dose regular insulin at baseline serum potassium levels >6 mmol/L in the treatment of hyperkalaemia.

“Using a reduced dose of 5 units of regular insulin has been proposed as a strategy to mitigate the risk of hypoglycaemia when treating hyperkalaemia,” according to the authors.

This study compared the effectiveness of reduced vs conventional dosed insulin for hyperkalaemia treatment. The authors reviewed electronic medication administration reports of conventional or reduced doses of insulin given to patients from July 2013 to September 2015. Reduction in serum potassium was the primary outcome.

A total of 92 administrations of reduced dose insulin and 309 administrations of conventional dose insulin were included in the review. There was no significant difference in potassium reduction between the two treatment groups (–0.096 mmol/L; p=0.2210).

In posthoc subgroup analysis of patients with serum potassium >6 mmol/L, results showed a lower decrease in potassium in the reduced dose insulin group compared to the conventional dose insulin group (difference, –0.238 mmol/L; p=0.018).

“Frequent monitoring of serum potassium and glucose after administration of insulin is necessary to confirm adequate response and avoidance of hypoglycaemia,” the authors said.

In contrast, a 2017 study reported that 5 units of insulin reduced serum potassium to the same extent as 10 units of insulin in patients with renal insufficiency and hyperkalaemia, but with a lower hypoglycaemia rate. [Pharmacotherapy 2017;37:1516-1522]

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Most Read Articles
29 Jul 2020
Adjunctive perampanel appears to be safe and effective for long-term treatment of patients with tonic‐clonic seizures, according to a posthoc analysis.
27 Apr 2020
Long-term use of brivaracetam as an adjunctive treatment is well tolerated and effective in patients with focal seizures or primary generalized seizures, as shown in a study.
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Rachel Soon, 24 Apr 2018

MIMS Pharmacist presents an overview of CoQ10's physiological role, as well as contemporary research on its pharmacology and effects.