Subcutaneous use of rapid insulin analog : an alternative treatment for atients with mild to moderate diabetic ketoacidosis

Abstract EN

Background: diabetic ketoacidosis (DKA) is a life-threatening condition that requires hospitalization in children with type 1 diabetes.

Many reports have indicated that low-dose insulin therapy is quite effective regardless of the route of administration, whether, intramuscular, or subcutaneous.

Aims : the aim of this study was to look for technical simplification and economic efficiency in the treatment of diabetic ketoacidosis (DKA) with subcutaneous use of the rapid-acting insulin analog and compare its use with regular intravenous insulin treatment.

Methods : A total of 80 consecutive patients admitted with DKA were randomly classified into 4 groups : Group 1: Patients with DKA on regular insulin by infusion pump, (infusion pump, n = 20), group 2 : patients with DKA on subcutaneous rapid onset of action-as part insulin analog (Novo log; Novo Nordisk) / 2 hrs, sc-2hr, n = 20), group 3: Patients with DKA on subcutaneous rapid onset of action-as part insulin analog (Novo log ; Novo Nordisk) / 1 hrs, (sc-lhr, n = 20), and group 4 : Patients with DKA on rapid insulin analog by continues subcutaneous insulin pump (CSII, n.= 20).

Results : the results of this study showed that there was no statistical difference between the 4 groups as regarding age in years, blood glucose in mg / dl before the starting of management of DKA, pH, serum HC03, serum K, anion gap, urine acetone and time needed for resolution of DKA by hours.

Conclusion : it could be concluded that management of any patient with mild to moderate DKA with good tissue perfusion can be treated with subcutaneous rapid insulin analog every 1 or 2 hours or to be treated by continuous insulin infusion pumps, if available with same results as giving regular insulin by intravenous infusion pumps.