Weight-based insulin dosing for acute hyperkalemia results in less hypoglycemia

J Hosp Med. 2016 May;11(5):355-7. doi: 10.1002/jhm.2545. Epub 2016 Jan 13.


Hyperkalemia treatment with intravenous insulin has been associated with hypoglycemia. This single-center, retrospective study compared the effects on hypoglycemia between weight-based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) compared to standard flat doses of 10 U among patients weighing less than 95 kg. Of the 132 charts randomly selected for review, hypoglycemic events (blood glucose <70 mg/dL) were reduced from 27.3% in the 10-U group to 12.1% in the weight-based group (P = 0.05). The number of affected patients was reduced with 19.7% in the 10-U group and 10.6% in the weight-based group (P = 0.22). The potassium-lowering effects of these 2 strategies were similar between groups. Female patients and those with baseline glucose values <140 mg/dL were at increased risk for hypoglycemia. Weight-based insulin dosing (0.1 U/kg) for acute hyperkalemia therapy resulted in less hypoglycemia without impacting potassium lowering. Journal of Hospital Medicine 2016;11:355-357. © 2016 Society of Hospital Medicine.

Publication types

  • Review

MeSH terms

  • Blood Glucose / drug effects
  • Body Weight / drug effects*
  • Female
  • Humans
  • Hyperkalemia / drug therapy*
  • Hypoglycemia / chemically induced*
  • Hypoglycemic Agents / administration & dosage*
  • Insulin / administration & dosage*
  • Male
  • Middle Aged
  • Retrospective Studies


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin