Diabetes Mellitus Q 56

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When a client is experiencing diabetic ketoacidosis, the insulin that would be administered is:

  

    A. Human NPH insulin

    B. Human regular insulin

    C. Insulin lispro injection

    D. Insulin glargine injection

    

    

Correct Answer: B. Human regular insulin

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Regular insulin (Humulin R) is short-acting insulin and is administered via IV with an initial dose of 0.3 units/kg, followed by 0.2 units/kg 1 hour later, followed by 0.2 units/kg every 2 hours until blood glucose becomes <13.9 mmol/L (<250 mg/dL). At this point, the insulin dose should be decreased by half, to 0.1 units/kg every 2 hours, until the resolution of DKA.

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Option A: NPH insulin is FDA-approved in the adult and pediatric population to control type 1 and type 2 diabetes mellitus. It is currently the most widely used basal insulin that simulates the physiological basal insulin action. American Diabetes Association guidelines recommend an NPH insulin dose of 0.4 to 1.0 units/kg/day subcutaneously to manage type 1 diabetes mellitus.

Option C: Insulin lispro is an insulin analog that is FDA-approved for the treatment of patients with diabetes mellitus types 1 and 2 to control hyperglycemia. Its off-label uses include treating patients with mild-to-moderate diabetic ketoacidosis, gestational diabetes mellitus, and mild-to-moderate hyperosmolar hyperglycemic state.

Option D: Insulin glargine is a manmade version of human insulin that is FDA approved to treat adults and children with type 1 diabetes and adults with type 2 diabetes to improve and maintain glycemic control. Insulin glargine is a long-acting insulin injected once daily and provides a basal level of insulin throughout the day.

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