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Criteria for Insulin Drip Discontinuation

  1. Discontinue insulin when:

    1. Bicarbonate level is ≥17mmol/L

    2. Anion gap is normalized

    3. And/or blood ketones are negative to small. 

  2.  Once the insulin drip is stopped, discontinue D10NS with additives if patient's blood glucose is stable

  3. Once DKA has resolved begin multiple daily injections insulin regimen or restart insulin pump.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.