Weight-based insulin dosing for acute hyperkalemia results in less hypoglycemia

Dauria T. Wheeler, Stephen J. Schafers, Tim A. Horwedel, Eli N. Deal, Garry S. Tobin

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Hyperkalemia treatment with intravenous insulin has been associated with hypoglycemia. This single-center, retrospective study compared the effects on hypoglycemia between weight-based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) compared to standard flat doses of 10 U among patients weighing less than 95 kg. Of the 132 charts randomly selected for review, hypoglycemic events (blood glucose <70 mg/dL) were reduced from 27.3% in the 10-U group to 12.1% in the weight-based group (P = 0.05). The number of affected patients was reduced with 19.7% in the 10-U group and 10.6% in the weight-based group (P = 0.22). The potassium-lowering effects of these 2 strategies were similar between groups. Female patients and those with baseline glucose values <140 mg/dL were at increased risk for hypoglycemia. Weight-based insulin dosing (0.1 U/kg) for acute hyperkalemia therapy resulted in less hypoglycemia without impacting potassium lowering.

Original languageEnglish
Pages (from-to)355-357
Number of pages3
JournalJournal of hospital medicine
Issue number5
StatePublished - May 1 2016


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