{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:43:22Z","timestamp":1785163402329,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To study the incidence of, and risk factors for, iatrogenic hypoglycaemia following GwI infusion in our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Context<\/jats:title><jats:p>Hyperkalaemia is a life\u2010threatening biochemical abnormality. Glucose\u2010with\u2010insulin (GwI) infusions form standard management, but risk iatrogenic hypoglycaemia (glucose\u00a0\u2264\u00a03.9\u00a0mmol\/L). Recently updated UK guidelines include an additional glucose infusion in patients with pretreatment capillary blood glucose (CBG) &lt; 7.0\u00a0mmol\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective analysis of outcomes for GwI infusions prescribed for hyperkalaemia from 1 January to 28 February 2019, extracted from the Newcastle upon Tyne Hospitals NHS Foundation Trust electronic platform (eRecord).<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>132 patients received 228 GwI infusions for hyperkalaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Incidence, severity and time to onset of hypoglycaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hypoglycaemia incidence was 11.8%. At least 1 hypoglycaemic episode occurred in 18.2% of patients with 6.8% having at least 1 episode of severe hypoglycaemia (&lt; 3.0\u00a0mmol\/L). Most episodes (77.8%) occurred within 3\u00a0h of treatment. Lower pretreatment CBG (5.9\u00a0mmol\/L [4.1\u00a0mmol\/L\u201011.2\u00a0mmol\/L], versus 7.6\u00a0mmol\/L [3.7\u00a0mmol\/L\u201031.3\u00a0mmol\/L], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.000) was associated with hypoglycaemia risk. A diagnosis of type 2 diabetes and treatment for hyperkalaemia within the previous 24\u00a0h were negatively associated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Within our inpatient population, around 1 in 8 GwI infusions delivered as treatment for hyperkalaemia resulted in iatrogenic hypoglycaemia. Higher pretreatment CBG and a diagnosis of type 2 diabetes were protective, irrespective of renal function. Our findings support the immediate change to current management, either with additional glucose infusions or by using glucose\u2010only infusions in patients without diabetes. These approaches should be compared via a prospective randomized study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14343","type":"journal-article","created":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T21:45:05Z","timestamp":1601156705000},"page":"176-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Iatrogenic hypoglycaemia following glucose\u2010insulin infusions for the treatment of hyperkalaemia"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7893-7352","authenticated-orcid":false,"given":"Su Ann","family":"Tee","sequence":"first","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Newcastle\u2010upon\u2010Tyne Hospitals NHS Foundation Trust  Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0129-4373","authenticated-orcid":false,"given":"Kerri","family":"Devine","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Newcastle\u2010upon\u2010Tyne Hospitals NHS Foundation Trust  Newcastle UK"},{"name":"Department of Diabetes &amp; Endocrinology Queen Elizabeth Hospital Gateshead Health NHS Foundation Trust  Gateshead UK"},{"name":"Translational &amp; Clinical Research Institute University of Newcastle\u2010upon\u2010Tyne  Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Potts","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Newcastle\u2010upon\u2010Tyne Hospitals NHS Foundation Trust  Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Javaid","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Queen Elizabeth Hospital Gateshead Health NHS Foundation Trust  Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9047-1556","authenticated-orcid":false,"given":"Salman","family":"Razvi","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Queen Elizabeth Hospital Gateshead Health NHS Foundation Trust  Gateshead UK"},{"name":"Translational &amp; Clinical Research Institute University of Newcastle\u2010upon\u2010Tyne  Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Quinton","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Newcastle\u2010upon\u2010Tyne Hospitals NHS Foundation Trust  Newcastle UK"},{"name":"Translational &amp; Clinical Research Institute University of Newcastle\u2010upon\u2010Tyne  Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Roberts","sequence":"additional","affiliation":[{"name":"Diabetes Research Group Swansea University  Swansea UK"},{"name":"Clinical Research Facility \u2010 Cork University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J.","family":"Leech","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology Newcastle\u2010upon\u2010Tyne Hospitals NHS Foundation Trust  Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2014.42577"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007135517950"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.08.015"},{"key":"e_1_2_8_5_1","unstructured":"UK Renal Association.Clinical Practice Guidelines: Treatment of acute hyperkalaemia in adults.https:\/\/renal.org\/wp-content\/uploads\/2017\/06\/hyperkalaemia-guideline-1.pdf. 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