Basal Insulin in the Management of Patients With Diabetic Ketoacidosis (DKA)

Launched by EMORY UNIVERSITY · Jan 9, 2008

Keywords

ClinConnect Summary

Diabetic ketoacidosis (DKA) is the most serious emergency in patients with diabetes. With an estimated 100,000 admissions per year in the United States, DKA is also the leading cause of death in children with type 1 diabetes, and accounts for a significant proportion of admissions in adult patients with type 1 and type 2 diabetes. The mainstay in the treatment of DKA involves the continuous intravenous (IV) infusion of regular insulin or the frequent subcutaneous (SC) injections of regular or rapid-acting insulin analogs. Multiple studies have reported successful protocols for insulin admin...

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Eligibility criteria

• Inclusion Criteria:
• • All patients admitted to Grady Memorial Hospital who meet diagnosis criteria of DKA and who are willing to participate in the study protocol will be considered candidates for inclusion into the study.
• • Diagnostic Criteria for DKA: Blood glucose \> 250 mg/dL, arterial or venous phenol hydroxylase (pH) \< 7.3, serum bicarbonate \< 18 milliequivalent/L, and moderate to severe ketonemia (acetoacetate ≥ 1:4 or βeta-hydroxybutyrate \> 3 mmol).
• Exclusion Criteria:
• • Hemodynamic instability (MAP \< 50 or patients requiring pressor)
• • Significant identifiable medical or surgical illness, including but not limited to: acute myocardial infarction, congestive heart failure; respiratory failure requiring mechanical ventilation; acute or chronic renal insufficiency (serum creatinine \> 3.0 mg/dl); end stage liver failure, and cirrhosis.
• • Patients with dementia or persistent altered mental status that would prevent collection of consent form and reliable information.
• • Pregnancy