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Complicating factors

Authoring team

There are two areas of concern when administering intravenous glucose and insulin therapy. These are:

  • the plasma potassium concentration should be monitored and the infusion altered accordingly:

  • Potassium concentration; Potassium supplement to each litre of 10% dextrose
  • < 3.5 mM; 40 mmol
  • 3.5 - 5.0 mM; 20 mmol
  • > 5.0 mM; 0 mmol



  • higher levels of insulin will be required in the following circumstances:
    • severe infection
    • in cardiac surgery where the bypass pump is primed with dextrose
    • if an adrenergic agent is used
    • if parenteral nutrition is employed
    • if adreno-suppressive doses of corticosteroids are in use

Ref: Robinson, R. and Stott, R., Medical Emergencies: Diagnosis and Management, 1993, 6th edition, Butterworth-Heinemann, p.172-3

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