Abstract
This study compared the efficacy and safety of Lispro insulin and regular insulin in the management of hyperglycemic emergencies (HE). Fifty patients who presented in HE to the Emergency unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife participated in the study. Hyperglycaemic emergency was diagnosed when plasma glucose level was > 17 mmol/L (300 mg/dl) in the presence of polyuria and polydipsia that warrants emergency hospital admission. Subjects in the Lispro insulin group had a statum dose of 0.3 IU/kg, while those in the regular insulin group had a statum dose of 20 IU equally split between the intravenous and intramuscular routes. Further insulin therapy was by the intramuscular route. Data was analysed using the Statistical package for social sciences (SPSS) version 11. Hyperglycaemia resolved within the first 8 hours in 60 and 40% percent of subjects in the lispro and regular insulin treated groups respectively. The time taken for resolution of hyperglycaemia was similar in both treatment groups, 6.6±0.8 hours for the lispro insulin group and 7.4±0.8 hours for the regular insulin group p = 0.51. The number of episodes of
hypoglycaemia and hypokalemia in the two treatment groups did not differ statistically (p = 1.0 and 0.38 respectively). Eight (16%) subjects died. Lispro insulin is a safe and efficacious alternative to regular insulin in the treatment of HE.
Keywords: Hyperglycaemic emergency, Lispro insulin, Regular insulin.
Résumé
Cette étude avait pour but de comparer l’efficacité et la sécurité de l’insuline Lispro et l’insuline régulière sur la gestion des urgences d’hyperglycémies (HE). Cinquante patients a l’unité d’urgence ayant des urgences d’hyper glycémiques dans le complexe universitaire Hospitalier d’Obafemi Awolowo, Ife participaient a l’étude. L’urgence hyperglycémique était diagnostiquée lorsque le taux du glucose sanguine était de > 17 mmol/L (300 mg/dl) en présence de la polyurie et polydipsie qui nécessitaient une admission hospitalière urgente. Les sujets dans le groupe de l’insuline Lispro avaient un dose de départ de 0.3 IU/kg, tan disque ceux dans le groupe de l’insuline régulier commençaient avec une dose de 20 IU partagée également entre les voies intraveineuse et intramusculaire ; Suivi de la thérapie a l’insuline était par voie intramusculaire. Les données étaient analysées en utilisant le logiciel SPSS version 11. Hyperglycémie se reconstituait dans les 8 heures chez 60 % et 40% aux groupes des sujets recevant l’insuline Lispro et régulier respectivement. Le temps mis pour la résolution de l’hyperglycémie était semblable aux deux groupes, 6.6 ± 0.8 heures pour le groupe recevant l’insuline lispro et 7.4 ± 0.8 heures pour le groupe recevant l’insuline régulier (p = 0.51). Le nombre des épisodes d’hypoglycémies et d’hypokaliémie chez les 2 groupes ne différenciaient pas statiquement (p = 1.0 et 0.38 respectivement). Huit (16%) des sujets mouraient. L’insuline Lispro est plus sécurisée et un alternatif efficace de l’insuline régulier pour le traitement des urgences hyper glycémiques.
Correspondence: Dr. Babatope Kolawole, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Nigeria. E-mail: kkole@oauife.edu.ng or bakolawole@gmail.com.
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