GKI infusion

From Ganfyd

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.

Advantages

• 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

Disadvantages

• 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.)