Indications & Dose: DIABETIC KETOACIDOSIS Mild IV Adult Loading dose 0.2-0.3U/kg followed by 0.2-0.3U/kg given by IM/SC | Moderate-to-severe IV Adult Loading dose 0.15U/kg, then continuous inf 0.1U/kg/h, if blood glucose levels do not fall by 50mg/dL within 1h, double the inf q1h. When blood glucose level is 250/300 mg/dL, reduce inf rate to 0.05-0.1U/kg/h Child Inf: 0.1U/kg/h. If IV not accessible, initial dose 0.1U/kg IM followed by 0.1U/kg/h IM/SC until acidosis is resolved | Newly diagnosed TYPE 1 DM SC Child Initially 0.5-1U/kg/d | Newly diagnosed TYPE 2 DM SC Adult Initially 0.5-1U/kg/d | Type 1 DM SC Adult Initially 0.2-1U/kg/d Child same as adult dose | TYPE 2 DIABETES MELLITUS SC Adult Initially 0.2-0.4U/kg

Precautions: Hypokalemia, hepatic/renal impairment

ADR: Serious: hypoglycemia, hypokalemia, palpitation, hypothermia, transient presbyopia, blurred vision, unconsciousness, peripheral edema, tachycardia, Others: headache, fatigue, hunger, weight gain, paresthesia, muscle weakness, mental confusion, pruritus, redness, urticaria, pallor

DDI: Serious Rosiglitazone/Pioglitazone increases risk of HF, Clozapine/CCBs/Corticosteroids/Hormonal Contraceptives/Loop diuretics/Olanzapine/Thiazides results in hyperglycemia

Diet: Before food

Monitor: Plasma glucose, electrolytes, HbA1c