Infusion pumps, insulin diabetic ketoacidosis

For persons with type 1 diabetes, insulin replacement therapy is necessary to sustain life. Pharmacologic insulin is administered by injection into the subcutaneous tissue using a manual injection device or an insulin pump that continuously infuses insulin under the skin. Interruption of the insulin replacement therapy can be life-threatening and can result in diabetic ketoacidosis or death. Diabetic ketoacidosis is caused by insufficient or absent insulin and results from excess release of fatty acids and subsequent formation of toxic levels of ketoacids. 

Use of a slow-infusion pump with a concentrated solution (insulin 1.0 unit/ml) is recommended. Insulin loss is minimised and control of dose is more accurate than when more dilute solutions are used. (For i.v. doses see diabetic ketoacidosis, below.) Insulin is suitable for adimistration by continuous i.v. infusion because its short t/ (5 min) means that the plasma concentration rapidly reaches steady state after initiating the infusion or altering its rate (5 X see p. 101). Long-acting (sustained-release) preparations must not be given i.v. 

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