Less hypoglycemia with weight-based insulin in hyperkalemia

(HealthDay)—Weight-based insulin dosing is associated with less hypoglycemia than standard dosing for patients with acute hyperkalemia weighing less than 95 kg, according to a study published online Jan. 13 in the Journal of Hospital Medicine.

Dauria T. Wheeler, Pharm.D., from the St. Louis College of Pharmacy, and colleagues conducted a single-center, retrospective study to compare the effects on hypoglycemia of weight-based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) versus standard flat doses of 10 U. Charts for 132 patients weighing less than 95 kg with acute hyperkalemia were randomly selected.

The researchers observed a reduction in hypoglycemic events from 27.3 percent in the 10-U group to 12.1 percent in the weight-based group (P = 0.05). There was a reduction in the number of affected patients, with 19.7 and 10.6 percent, respectively, in the 10-U and weight-based groups (P = 0.22). Similar potassium-lowering effects were seen between the groups. The risk of hypoglycemia was increased for female patients and for those with baseline glucose values <140 mg/dL.

"Weight-based insulin dosing (0.1 U/kg) for acute hyperkalemia therapy resulted in less hypoglycemia without impacting potassium lowering," the authors write.

One author disclosed financial ties to the pharmaceutical industry.