Soluble human insulin — DKA infusion

Pregnancy & gynaecology-specific. Every dose row is source-referenced; verify against institutional protocols.

Soluble human insulin — DKA infusionEMERGENCY KITEndocrine Metabolic

Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.

Soluble human insulin — DKA infusion: indication-specific regimens
Indication	Dose	Route	Frequency	Duration / preparation	Maximum	Monitoring / cautions
Pregnancy DKA, including euglycaemic DKA; urgent monitored obstetric/diabetes care JBDS-IP / Diabetes UKchecked	0.1 units/kg/hour IV; no routine IV insulin bolus. Consider 0.05 units/kg/hour once glucose <14 mmol/L alongside glucose infusion	IV infusion pump	Continuous with hourly response-based review	Continue until ketones <0.6 mmol/L AND venous pH >7.3, clinical recovery and safe transition; not merely until glucose normalises · Using U-100 SOLUBLE insulin: 50 units =0.5 mL; add to 49.5 mL sodium chloride 0.9% for FINAL 50 mL =1 unit/mL. At 0.1 units/kg/h, 70 kg =7 units/h =7 mL/h. NEVER use cloudy NPH IV	No universal fixed hourly ceiling; inadequate ketone fall needs line/pump and dose reassessment. Potassium <3.5 mmol/L requires urgent senior-led replacement and insulin review	Monitor Hourly glucose and blood ketones; frequent VBG, potassium and electrolytes; target ketone fall ≥0.5 mmol/L/h Add 10% glucose at 125 mL/h when glucose <14 mmol/L; euglycaemic pregnancy DKA may require glucose from the start Continue usual long-acting basal insulin unless specialist contraindication; overlap IV insulin for 30–60 min after the appropriate subcutaneous meal dose during transition Contraindications / cautions Severe hypokalaemia, shock, renal/cardiac disease require immediate specialist adaptation; never prescribe insulin without a fluid/potassium plan

Pregnancy safety

Pregnancy DKA requires a joint obstetric/diabetes/critical-care plan.

Lactation

Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.