When to Convert to SC Insulin

Fig 15: Continue intravenous therapy until the child is well and eating and drinking without ketoacidosis

• Continue IV therapy until:
  • pH normal or blood ketones <1.0mmol/L
  • Urinary ketones may still be positive60-61
  • Clinically well
  • Eating & drinking
• First give SC insulin (usual regimen of basal and bolus)
  • At least 30 minutes before stopping the infusion
  • 60 minutes if on an insulin pumps
• Then stop insulin infusion
  • The aim is to avoid rebound hyperglycaemia

On-going home management & follow-up should be discussed with the young person’s Consultant or Diabetic Specialist Nurse.