A mixture of glucose, K+ (potassium) and insulin. Commonly used peri-operatively as means of providing fluid together with glucose and insulin to insulin-dependent patients, i.e. type I diabetics and some type II diabetics.
The composition can be remembered by 10-10-10:
- 10 mmol of potassium chloride
- 10% glucose (500ml)
- 10 units (or sometimes more) of rapid-acting insulin (e.g. Actrapid™)
- rate 100ml/hour.
This delivers about 2 units of intravenous insulin per hour, which approximates to the amounts given using an insulin sliding scale when the patient glucose levels are in single digits.
- By giving all 3 components together, unlikely to cause hypoglycaemia or hypokalaemia (which is a risk if insulin given by itself).
- Small amount of calories (only 10g glucose per hour)
- Provides fluid, but mainly as electrolyte-free water.
- Easy to remember
- Not designed for fine glycaemic control: if blood glucose levels are high, the remainder of the bag could be discarded to make up a new bag with more insulin, but this is not elegant.
- The volume of fluid is not always required.
- Could aggravate hyponatraemia.
- Not patient specific (see evidence base for particular indications on page on insulin sliding scale.)