What is the initial insulin bolus dose for a patient with hyperglycemia?

In the management of hyperglycemia, particularly in cases such as diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS), it is crucial to administer an appropriate initial insulin bolus to effectively lower blood glucose levels. The recommended initial insulin bolus for adults is typically 0.1 unit per kilogram of body weight. This dosing is considered adequate to initiate an effective metabolic response without causing rapid drops in blood glucose, which could lead to hypoglycemia.

Administering this bolus helps to begin the process of correcting the hyperglycemic state safely, while the patient is often monitored for additional needs and titration of insulin based on ongoing blood glucose levels. Using a dose of 0.1 unit/kg facilitates a controlled and effective initial approach to manage the elevated glucose levels that may pose significant health risks if not addressed.

While higher doses can potentially be used based on clinical discretion and guidelines, the standard and conservative initial approach is to start with this specific dose to balance efficacy and safety.