Role of Insulin Glargine in Early Phase of Treatment of Diabetic Ketoacidosis

Abstract

Diabetic ketoacidosis (DKA) is a common cause of intensive care unit (ICU) admission, with high morbidity and mortality rates. The current body of evidence shows that DKA is still the main cause of death in children and adolescents with type 1 diabetes mellitus (T1DM) and it results in long-term sequelae in 10-25% of survivals. On the other hand, insulin Glargine is a long-acting basal human insulin analogue which reportedly shows no remarkable plasma insulin peaks, and physiologically mimics the normal basal insulin concentrations. Recently, a growing body of evidence has suggested that adding insulin Glargine to the standard regimen may facilitate the transition from an intravenous infusion of insulin to subcutaneous injection in the recovery of patients with DKA. Insulin Glargine was reported to be safe and effective in reducing the time of recovery from DKA, without increasing the episodes of hypoglycemia and hypokalemia. However, there is a scarcity in the published literature which evaluates the role of insulin Glargine in DKA. Therefore, the present double-blind randomized controlled trial aimed to investigate the effect of adding Insulin Glargine to the standard regimen of treatment of DKA on the recovery process of patients regarding the amount of intravenous insulin infusion and the duration of