{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:51:15Z","timestamp":1787500275165,"version":"build-2736575974"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hyperkalaemia is a very common electrolyte disorder encountered in hospitalised patients. Although hypoglycaemia is a frequent complication of insulin therapy, it is often under-appreciated. We conducted a scoping review of this important complication, and of other adverse effects, of the treatment of hyperkalaemia in hospitalised adults to map existing research on this topic and to identify any knowledge gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      We followed the PRISMA-ScR guidelines. Studies were eligible for inclusion if they reported on any adverse effects in hospitalised patients \u226518-years-old, with hyperkalaemia receiving treatment that included insulin. All eligible research from 1980 to 12 October 2021 were included. We searched Medline (PubMed), Embase (Ovid), the Cochrane Library, CINHAL, Africa-Wide Information, Web of Science Core Collection, LILACS and Epistemonikos. The protocol was prospectively registered with the Open Science Framework (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/osf.io\/x8cs9\" xlink:type=\"simple\">https:\/\/osf.io\/x8cs9<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty-two articles were included. The prevalence of hypoglycaemia by any definition was 17.2% (95% CI 16.6\u201317.8%). The median timing of hypoglycaemia was 124 minutes after insulin administration (IQR 102\u2013168 minutes). There were no differences in the prevalence of hypoglycaemia when comparing insulin dose (&lt;10 units vs. \u226510 units), rate of insulin administration (continuous vs. bolus), type of insulin (regular vs. short-acting) or timing of insulin administration relative to dextrose. However, lower insulin doses were associated with a reduced prevalence of severe hypoglycaemia (3.5% vs. 5.9%, P = 0.02). There was no difference regarding prevalence of hypoglycaemia by dextrose dose (\u226425 g vs. &gt;25 g); however, prevalence was lower when dextrose was administered as a continuous infusion compared with bolus administration (3.3% vs. 19.5%, P = 0.02). The most common predictor of hypoglycaemia was the pre-treatment serum glucose concentration (n = 13 studies), which ranged from &lt; 5.6\u20137.8 mmol\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is the first comprehensive review of the adverse effects following insulin therapy for hyperkalaemia. Hypoglycaemia remains a common adverse effect in hospitalised adults. Future randomised trials should focus on identifying the optimal regimen of insulin therapy to mitigate the risk of hypoglycaemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0268395","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T13:49:27Z","timestamp":1652363367000},"page":"e0268395","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Hypoglycaemia due to insulin therapy for the management of hyperkalaemia in hospitalised adults: A scoping review"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9801-1300","authenticated-orcid":true,"given":"Mogamat-Yazied","family":"Chothia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Humphrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anel","family":"Schoonees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usuf Mohamed Ebrahim","family":"Chikte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4900-0231","authenticated-orcid":true,"given":"Mogamat Razeen","family":"Davids","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"pone.0268395.ref001","article-title":"How common is hyperkalaemia? A systematic review and meta-analysis of the prevalence and incidence of hyperkalaemia reported in observational studies","author":"T Humphrey","year":"2021","journal-title":"Clin Kidney J"},{"issue":"5","key":"pone.0268395.ref002","doi-asserted-by":"crossref","first-page":"e0154963","DOI":"10.1371\/journal.pone.0154963","article-title":"Optimal dose and method of administration of intravenous insulin in the management of emergency hyperkalemia: a systematic review","volume":"11","author":"Z Harel","year":"2016","journal-title":"PLoS One"},{"key":"pone.0268395.ref003","article-title":"Clinical practice guidelines: treatment of acute hyperkalaemia in adults","author":"A Alfonzo","year":"2020","journal-title":"UK Renal Association"},{"key":"pone.0268395.ref004","first-page":"CD010344","article-title":"Pharmacological interventions for the acute management of hyperkalaemia in adults","volume":"10","author":"J Batterink","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"pone.0268395.ref005","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.kint.2015.11.018","article-title":"Treatment of hyperkalemia: something old, something new","volume":"89","author":"RH Sterns","year":"2016","journal-title":"Kidney Int"},{"issue":"10","key":"pone.0268395.ref006","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/j.1463-1326.2007.00802.x","article-title":"Insulin therapy in renal disease","volume":"10","author":"P Iglesias","year":"2008","journal-title":"Diabetes Obes Metab"},{"issue":"2","key":"pone.0268395.ref007","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jcrc.2014.10.019","article-title":"Insulin infusion therapy in critical care patients: regular insulin vs short-acting insulin. 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Beltrami-Moreira","year":"2020","journal-title":"Endocrine Practice"},{"key":"pone.0268395.ref016","unstructured":"Binz S, Konowitz NP, Bennett S, Miller J. The highest risk for hypoglycemia after treatment for hyperkalemia is in the emergency department. Available at: https:\/\/scholarlycommons.henryford.com\/emergencymedicine_mtgabstracts\/139\/. Accessed February 10, 2022."},{"issue":"4","key":"pone.0268395.ref017","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0002-9343(88)80086-X","article-title":"Effect of various therapeutic approaches on plasma potassium and major regulating factors in terminal renal failure","volume":"85","author":"A Blumberg","year":"1988","journal-title":"Am J Med"},{"issue":"5","key":"pone.0268395.ref018","doi-asserted-by":"crossref","first-page":"284","DOI":"10.12788\/jhm.3145","article-title":"Preventing hypoglycemia following treatment of hyperkalemia in hospitalized patients","volume":"14","author":"CK Boughton","year":"2019","journal-title":"J Hosp Med"},{"issue":"6","key":"pone.0268395.ref019","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1177\/1062860618764610","article-title":"Assessing the impact of an order panel utilizing weight-based insulin and standardized monitoring of blood glucose for patients with hyperkalemia","volume":"33","author":"K Brown","year":"2018","journal-title":"Am J Med Qual"},{"issue":"5","key":"pone.0268395.ref020","doi-asserted-by":"crossref","first-page":"833","DOI":"10.5811\/westjem.2019.7.42996","article-title":"Incidence and causes of iatrogenic hypoglycemia in the emergency department","volume":"20","author":"C Chittineni","year":"2019","journal-title":"West J Emerg Med"},{"issue":"1","key":"pone.0268395.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000358836","article-title":"Bolus administration of intravenous glucose in the treatment of hyperkalemia: a randomized controlled trial","volume":"126","author":"M-Y Chothia","year":"2014","journal-title":"Nephron Physiol"},{"key":"pone.0268395.ref022","doi-asserted-by":"crossref","DOI":"10.1093\/ndt\/gfx140.SP084","article-title":"Human insulin vs aspart and incidence of hypoglycemia in the management of hyperkalemia. 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Predictors of Iatrogenic Hypoglycemia in Treatment of Hyperkalemia. Available at: https:\/\/scholarlycommons.henryford.com\/internalmedicine_mtgabstracts\/102\/. Accessed February 10, 2022."},{"key":"pone.0268395.ref027","article-title":"Hypoglycemia is a Common Complication of Insulin Administration for Treatment of Hyperkalemia in the ED: 476","volume":"23","author":"B. Driver","year":"2016","journal-title":"Acad Emerg Med"},{"issue":"6","key":"pone.0268395.ref028","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/2042098618768725","article-title":"Impact of dextrose dose on hypoglycemia development following treatment of hyperkalemia","volume":"9","author":"N Farina","year":"2018","journal-title":"Ther Adv Drug Saf"},{"issue":"3","key":"pone.0268395.ref029","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1177\/0897190018799220","article-title":"Reduced versus conventional dose insulin for hyperkalemia treatment","volume":"33","author":"J Garcia","year":"2020","journal-title":"J Pharm Pract"},{"key":"pone.0268395.ref030","unstructured":"Hain M, Fox H, Celmins L, Szwak JA. Effects of Utilization of an Insulin\/Dextrose Order Panel for Hyperkalemia for the Prevention of Hypoglycemia. 2020. American College of Clinical Pharmacy Virtual Annual Meeting. Available at: https:\/\/accp.confex.com\/accp\/2020am\/mediafile\/Handout\/Paper55336\/Hain_Effects%20of%20Utilization%20of%20an%20InsulinDextrose%20Order%20Panel%20for%20Hyperkalemia%20for%20Prevention%20of%20Hypoglycemia.pdf. Accessed February 10, 2022."},{"issue":"suppl. 3","key":"pone.0268395.ref031","doi-asserted-by":"crossref","first-page":"gfaa142.P1655","DOI":"10.1093\/ndt\/gfaa142.P1655","article-title":"Hyperkalaemia in prevalent kidney transplant recipients","volume":"35","author":"T Humphrey","year":"2020","journal-title":"Nephrol Dial Transplant"},{"key":"pone.0268395.ref032","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ejim.2021.09.018","article-title":"Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose","volume":"95","author":"TJ Humphrey","year":"2022","journal-title":"Eur J Intern Med"},{"issue":"3","key":"pone.0268395.ref033","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1177\/0018578718779012","article-title":"Hypoglycemia associated with insulin use during treatment of hyperkalemia among emergency department patients","volume":"54","author":"BC Jacob","year":"2019","journal-title":"Hosp Pharm"},{"issue":"6","key":"pone.0268395.ref034","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.ajem.2019.158374","article-title":"Assessment of intravenous insulin dosing strategies for the treatment of acute hyperkalemia in the emergency department","volume":"38","author":"KP Keeney","year":"2020","journal-title":"Am J Emerg Med"},{"issue":"3","key":"pone.0268395.ref035","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1159\/000188917","article-title":"Combined effect of bicarbonate and insulin with glucose in acute therapy of hyperkalemia in end-stage renal disease patients","volume":"72","author":"H-J Kim","year":"1996","journal-title":"Nephron"},{"issue":"9","key":"pone.0268395.ref036","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0011-393X(02)80060-1","article-title":"Insulin dose versus rate of potassium decrease in the treatment of hyperkalemia with iv insulin during extracorporeal circulation: An observational study","volume":"63","author":"H Kocoglu","year":"2002","journal-title":"Curr Ther Res"},{"issue":"4","key":"pone.0268395.ref037","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/j.annemergmed.2019.08.021","article-title":"18 Improving the Safety of Insulin Treatment for Hyperkalemia","volume":"74","author":"N Konowitz","year":"2019","journal-title":"Ann Emerg Med"},{"issue":"12","key":"pone.0268395.ref038","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1002\/phar.2038","article-title":"A comparison of insulin doses for the treatment of hyperkalemia in patients with renal insufficiency","volume":"37","author":"HA LaRue","year":"2017","journal-title":"Pharmacotherapy"},{"key":"pone.0268395.ref039","unstructured":"Lawes S, Authority PPS, Grissinger M. Treating Hyperkalemia: Avoid Additional Harm When Using Insulin and Dextrose. Available at: http:\/\/patientsafety.pa.gov\/ADVISORIES\/Pages\/201709_hyperkalemia.aspx. Accessed February 10, 2022."},{"issue":"3","key":"pone.0268395.ref040","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/oxfordjournals.ndt.a091860","article-title":"Treatment of hyperkalaemia in renal failure: salbutamol vs. insulin","volume":"4","author":"X Lane","year":"1989","journal-title":"Nephrol Dial Transplant"},{"issue":"6","key":"pone.0268395.ref041","first-page":"693","article-title":"Management of acute hyperkalemia using a standardized, evidence-basedorder set and its role in reducing hypoglycemic events","volume":"32","author":"S Lim","year":"2019","journal-title":"J Pharm Pract"},{"issue":"1","key":"pone.0268395.ref042","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3109\/08860229309065576","article-title":"Should glucose be administered before, with, or after insulin, in the management of hyperkalemia?","volume":"15","author":"D Ljuti\u0107","year":"1993","journal-title":"Ren Fail"},{"key":"pone.0268395.ref043","first-page":"A108","article-title":"Improving Detection of Hypoglycemia with Standardized Blood Glucose Checks after Administration of Insulin for Hyperkalemia Treatment","volume":"66","author":"HW Macmaster","year":"2017","journal-title":"Diabetes"},{"issue":"suppl 1","key":"pone.0268395.ref044","doi-asserted-by":"crossref","first-page":"400","DOI":"10.2337\/db18-400-P","article-title":"Decreasing Incidence of Postinsulin Hypoglycemia for Hyperkalemia Treatment","volume":"67","author":"HW Macmaster","year":"2018","journal-title":"Diabetes"},{"key":"pone.0268395.ref045","first-page":"1082","article-title":"Comparison of aminophylline and insulin-dextrose infusions in acute therapy of hyperkalemia in end-stage renal disease patients","volume":"49","author":"S Mahajan","year":"2001","journal-title":"J Assoc Physicians India"},{"key":"pone.0268395.ref046","article-title":"Boshara P; Hamdi MI, Szpunar S, Topf J. 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Risk Factors for Hypoglycemia after Insulin-based Acute Hyperkalemia Treatment","volume":"64","author":"S Wu","year":"2015","journal-title":"Diabetes"},{"issue":"3","key":"pone.0268395.ref065","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.ajem.2019.09.003","article-title":"Assessment of dextrose 50 bolus versus dextrose 10 infusion in the management of hyperkalemia in the ED","volume":"38","author":"I Yang","year":"2020","journal-title":"Am J Emerg Med"},{"issue":"4","key":"pone.0268395.ref066","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1177\/0018578719841035","article-title":"Effect of a standardized treatment panel on hypoglycemic events in hospitalized acute hyperkalemic patients treated with intravenous regular insulin","volume":"55","author":"A Zuern","year":"2020","journal-title":"Hosp Pharm"},{"issue":"2","key":"pone.0268395.ref067","first-page":"CD003235","article-title":"Emergency interventions for hyperkalaemia","author":"BA Mahoney","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"pone.0268395.ref068","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/phar.2596","article-title":"Reduced Alternative Insulin Dosing in Hyperkalemia: a Meta\u2010Analysis of Effects on Hypoglycemia and Potassium Reduction","volume":"41","author":"K Moussavi","year":"2021","journal-title":"Pharmacotherapy"},{"issue":"1","key":"pone.0268395.ref069","article-title":"Efficacy and safety of the pharmacotherapy used in the management of hyperkalemia: a systematic review","volume":"17","author":"FR Varallo","year":"2019","journal-title":"Pharm Pract"},{"issue":"2","key":"pone.0268395.ref070","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1080\/22201009.2009.10872202","article-title":"A comparison of five glucometers in South Africa","volume":"14","author":"Y Essack","year":"2009","journal-title":"J Endocrinology Metab Diabetes S Afr"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0268395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T08:16:33Z","timestamp":1700554593000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0268395"}},"subtitle":[],"editor":[{"given":"Robert Jeenchen","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,5,12]]},"references-count":70,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,12]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0268395","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,12]]}}}