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Review
. 2022 Oct 26;14(10):e30721.
doi: 10.7759/cureus.30721. eCollection 2022 Oct.

Efficacy and Safety of Intravenous Insulin in Treatment of Patient With Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis

Kareema S Alshurtan  1 , Osama Alnizari  2 , Hadi Aldarwish  2 , Ali A Al-Tufaif  2
Affiliations
Review

Efficacy and Safety of Intravenous Insulin in Treatment of Patient With Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis

Kareema S Alshurtan et al. Cureus. .

Abstract

The most common acute hyperglycemic emergency is diabetic ketoacidosis (DKA). DKA is one of the leading causes of Type 1 diabetes (T1D) related deaths in people aged 30 and under. In this meta-analysis, the Overall use of IV insulin in patients with mild/moderate vs. severe diabetic ketoacidosis was compared in randomized controlled trial articles from January 2011 to December 2021 using EMBASE, Medline, and CENTRAL. Only 8 of 3258 studies met the inclusion criteria. This review shows that intravenous insulin can significantly decrease plasma glucose and potassium levels in mild/moderate cases and severe cases. However, it can decrease the resolution time of acidosis more quickly in mild/moderate cases than in severe cases. In the current meta-analysis, the use of IV insulin is secure and efficient. There was no discernible difference in the effectiveness of IV insulin between mild/moderate and severe DKA.

Keywords: diabetes mellitus; diabetic coma; diabetic ketoacidosis; intravenous insulin; subcutaneous insulin.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flow chart of the systematic review
References- [15-22]
Figure 2
Figure 2. Forest plot showing effect size of regular insulin on plasma glucose
Figure 3
Figure 3. Forest plot showing effect size of regular insulin on pH
Figure 4
Figure 4. Forest plot showing the effect size of regular insulin on potassium
Figure 5
Figure 5. Forest plot showing effect size of regular insulin on time till resolution of acidosis
See this image and copyright information in PMC

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