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Intravenous insulin-dextrose repetition for hyperkalemia: How can we avoid subsequent hypoglycemia?

Published:February 07, 2022DOI:https://doi.org/10.1016/j.ejim.2022.01.037
      According to Humphrey and colleagues, one-third of patients with intravenous insulin-dextrose (IDex) for hyperkalemia needed repeated treatments with IDex [
      • Humphrey T.J.L.
      • James G.
      • Wilkinson I.B.
      • Hiemstra T.F.
      Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose.
      ]. Besides, approximately 20% of patients who underwent IDex developed hypoglycemia with a serum glucose level <4 mmol/L. Thus, the authors concluded that physicians should monitor serum glucose levels after IDex treatment. This study focused on the sequential changes in serum potassium and glucose levels and seemed helpful in actual clinical settings. However, I would like to raise one issue that would have potentially affected the results of this study: emergency hyperkalemia treatments other than IDex.

      Keywords

      Abbreviation:

      IDex (insulin-dextrose)
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      References

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        Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose.
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