Data from: Hypoglycemia Following intravenous insulin plus glucose for hyperkalemia in patients with impaired renal function

Background: Hypoglycemia is a serious complication following the
administration of insulin for hyperkalemia. We determined the incidence of
hypoglycemia and severe hypoglycemia (blood glucose <70 or ≤40
mg/dl, respectively) in a cohort of AKI and non-dialysis dependent CKD
patients who received an intravenous infusion of insulin plus glucose to
treat hyperkalemia. Methods: We retrospectively reviewed charts of all AKI
and non-dialysis dependent CKD patients who received 10 U of insulin plus
50 g glucose to treat hyperkalemia from December 1, 2013 to May 31, 2015
at our Department. Results: One hundred sixty four episodes of
hyperkalemia were treated with insulin plus glucose and were eligible for
analysis. Serum potassium levels dropped by 1.18 ± 1.01 mmol/l. Eleven
treatments (6.1%) resulted in hypoglycemia and two (1.2%) in severe
hypoglycemia. A lower pretreatment blood glucose tended to associate with
a higher subsequent risk of hypoglycemia. Age, sex, renal function, an
established diagnosis of diabetes or previous treatment were not
associated with the development of this complication. We did not register
any significant adverse events. Conclusion: Our intravenous regimen
combining an infusion of insulin plus glucose effectively reduced serum
potassium levels compared to previous studies and associated a low risk of
symptomatic hypoglycemia and other complications.