Budi Suprapti and Nugroho and Endang Martiniani and Sony Wibisono (2011) Penggunaan Insulin pada Pasien Diabetes Mellitus dengan Komplikasi Akut Ketoasidosis. Majalah Farmasi Airlangga, 9 (2). pp. 22-28. ISSN 0852-1050

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Abstract

Diabetic ketoacidosis (DKA) is one of the serious complications of diabetes mellitus with mortality up to 10%. DKA is marked by Kussmaid breathing with the smell of ketones, can be accompanied by a decrease in mental status, coma and death. Therefore, management of DKA therapy must be performed quickly and appropiately. This study aims to examine the use of insulin in DKA patients in both phase I and phase II as well as drug related problems related to the use of insulin. The study was conducted in hospitalized patients at Internal Department, dr. Soetomo Hospital Surabaya in the period March 15 to June 15, 2011. During the period of study period there were 13 patients diabetes mellitus with DKA, with 15-79 years of age distribution and the greater prevalence in women (77%). The biggest precipitation factor of DKA is sepsis (92%). Based on the classification of DKA, there were 30.7% of patients with mild DKA, 38.6% patients with moderate and 30.7% patients with severe DK4. Type of insulin used in these patients were short-acting insulin ( RHI), rapid-acting insulin (Aspart) and long acting insulin (Glargine). For phase I, all patients received rapid insulin regulation with RHI, with the formula (n-1) x 4 units (n is first figures blood glucose). Insulin pump was used in unstable blood glucose condition, using Aspart or RHI insulin. For phase II or maintenance (blood glucose <250 mg/dL) used RHI or Aspart insulin SC with dose of 3 x 4-14 units or /and glargine with dose of 1 x 10-12 units. DRPs found in this group of patients w ere is hypoglycaemia (7.7%), hypokalemia (30.8%) as well as potential interactions with other drugs (23.1%). There were 46% patients die. In conclusion. DKA is a complication of DM w ith high mortality, which needed quick and appropiate insulin regimen for the handling of phase I and phase II DKA, dosage regimen dpend on BG level. Insulin use is likely cause DRP, therefore require attention and rapid handling of the health care team.

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