Neonatal Hyperglycemia Mx

Insulin Infusion:

Dose: 0.02 -0.1 unit/kg/ht, start with 0.02 unit/kg/hr, gradually increase the dose to titrate the blood glucose level.

Measurement of insulin dose: 

Measure insulin to be given for 6 hours then add with 6 hour's IV fluid and then start to infuse.

Ideal fluid : Normal saline.

Preparation of insulin: take 10 unit of insulin in 100 unit insulin syringe + 90 unit

distilled water after dilution discard 90 unit ----then again add 90 unit D/W. After this

dilution, required amount of insulin is to be infused.

Follow up:

• Check Capillary Blood Glucose (CBG) hourly
• Titrate insulin dose according to the blood glucose level
  
• Monitor serum potassium level during insulin therapy
  

Example:

A 7 days old baby, weighing 3 Kg, lethargic with poor reflex activity, blood glucose was found 20 mmol/L. How will you calculate insulin for the baby?

Calculation:

Total insulin requirement = insulin(short acting Actrapid) dose x body weight x correction time

= 0.02 unit x 3 Kg x 6 hours

= 0.36 unit(36 IU)

Insulin (36 unit) in IV Nuid over 6 hours after double dilution to be given to the baby

🛂Remember: ( The calculated insulin dose = same amount of insulin after double dilution, like 0.36 unit = 36 unit of insulin after double dilution as 1 unit insulin preparation contain 0.01 unit insulin of 100 unit insulin syringe