Clinical Value of Combined Fluid Therapy and Low-Dose Insulin in the Treatment of Diabetic Non-Ketotic Hyperosmolar Coma

XU Nannan; ZHANG Fang; FAN Kuanlu

doi:10.13919/j.issn.2095-6274.ZHJY202501032

Abstract：Objective To explore the clinical value of combined fluid therapy and low-dose insulin in the treatment of hyperosmolar nonketotic diabetic coma(HNDC)in elderly patients.Methods A retrospective anal-ysis was conducted on the clinical data of 92 elderly patients diagnosed with HNDC who were treated at Xuzhou Mining Group General Hospital between January 2020 and June 2024.Patients were divided into two groups based on the different emergency treatment protocols:the observation group(n=46)received combined fluid therapy with low-dose insulin,while the control group(n=46)received standard fluid therapy with high-dose insulin.We com-pared the improvement of relevant biochemical parameters,time to resolution of clinical symptoms,incidence of adverse reactions,and mortality between the two groups.Results Following treatment,both groups exhibited significant improvements in various biochemical parameters,including substantial reductions in blood glucose,se-rum sodium,blood urea nitrogen,and plasma osmolality(P＜0.001),along with a significant increase in serum po-tassium levels(P＜0.001).Notably,the observation group showed significantly lower levels of blood glucose,serum sodium,blood urea nitrogen,and plasma osmolality compared to the control group(P＜0.001),while serum potassi-um levels were significantly higher(P＜0.001).The observation group also demonstrated significantly shorter times for correction of dehydration,normalization of consciousness,and restoration of osmolality compared to the control group(all P＜0.001).The overall incidence of adverse reactions in the observation group was significantly lower than that in the control group(P＜0.05),and the mortali-ty rate was also significantly reduced in the observation group(P＜0.05).Conclusion The emergency treat-ment protocol combining fluid therapy with low-dose insulin can effectively promote the recovery of consciousness in elderly patients with HNDC,improve dehydration status,rapidly correct osmolality and biochemical parameters,and reduce the incidence of complications.