The effect on mortality of low-dose insulin therapy for diabetic ketoacidosis.

The presentation, treatment, and outcome in 353 episodes of diabetic ketoacidosis have been examined to assess the effect of low-dose insulin therapy on mortality. There were 19 deaths during the period of study, with a mortality rate of 4.4% for patients treated with infrequent large doses of soluble insulin and 4.6% for patients treated with frequent intramuscular injections or continuous infusion of insulin. We conclude that in a center which practices an intensive care approach to the management of diabetic ketoacidosis, the use of a low-dose insulin regimen has not altered mortality.