Efficiency of Human Insulin (recombinant DNA) in the Treatment of Diabetic Ketoacidosis and Severe Nonketoacidotic Hyperglycemia

Human insulin (recombinant DNA) was compared with pork insulin in the treatment of diabetic ketoacidosis and severe nonketoacidotic hyperglycemia using a continuous, intravenous, low-dose regimen. Seven patients (age range 48 ± 26 yr, mean ± SD) with diabetic ketoacidosis and three (52, 65, and 70 yr) with nonketoacidotic hyperglycemia were studied. In the ketoacidotic group the initial values of blood glucose, pH, and base excess were 808 ± 353 mg/dl, 7.06 ± 0.1 , and −22.8 ± 5.9 mmol/L, respectively. The mean initial values of blood glucose and osmolality of the three patients with nonketoacidotic hyperglycemia were 731 ± 127 mg/dl and 355 ± 49 mosmol/kg, respectively. Within 24 h insulin therapy led to continuous improvement in blood glucose to 187 ± 90 (ketoacidotic patients) and 172 ± 28 mg/dl (nonketoacidotic group) and normalization of pH, base excess, and osmolality. The mean insulin requirement was 84 ± 45 U/24 h in ketoacidotic and 86 ± 18 U/24 h in nonketoacidotic patients, respectively. The comparison groups receiving pork insulin did not differ significantly in either clinical or initial and subsequent biochemical data or in insulin requirement.