Insulin-dextrose vs glucose-only therapy for the treatment of hyperkalaemia

Hyperkalaemia is a potentially life-threatening condition caused by high blood potassium levels. It is commonly treated with insulin and glucose, but insulin can lower blood sugar too much, leading to hypoglycaemia—a condition that can cause confusion, shakiness, or even loss of consciousness. We want to find out whether glucose alone, without insulin, can safely and effectively lower potassium levels in people without diabetes. This may be possible because glucose stimulates the body to produce its own insulin. We are conducting a clinical trial at the Royal Brisbane and Women’s Hospital Emergency and Trauma Centre to compare standard insulin–glucose therapy with glucose-only treatment. The trial will assess both safety (risk of hypoglycaemia) and effectiveness (potassium reduction). If glucose-only therapy is found to be safer and just as effective, it could change the standard treatment for hyperkalaemia.