ArticleIndian journal of pharmacology2011
Managing diabetic ketoacidosis in non-intensive care unit setting: Role of insulin analogs.
Article in Indian journal of pharmacology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Subcutaneous fast-acting insulin analogues ± long-acting insulin vs IV insulin infusion in DKA: updated meta-analysis of randomised trials.Endocrine · 2025Pooled it
- A systematic review and meta-analysis comparing outcomes between using subcutaneous insulin and continuous insulin infusion in managing adult patients with diabetic ketoacidosis.BMC endocrine disorders · 2024Pooled it
- Subcutaneous rapid-acting insulin analogues for diabetic ketoacidosis.The Cochrane database of systematic reviews · 2016Pooled it
- Trial
- Diabetic Ketoacidosis: Considerations and Residual Controversies in Management After the 2024 ADA, EASD, JBDS, AACE, and DST Joint ConsensusEndocrine, metabolic & immune disorders drug targets · 2026Review
- Subcutaneous Insulin in Diabetic Ketoacidosis (SQuID): A Nursing-Led Protocol Implementation.Journal of emergency nursing · 2025Article
- 2025 Clinical Practice Guidelines for Diabetes Management in Korea: Recommendation of the Korean Diabetes Association.Diabetes & metabolism journal · 2025Article
- Re-starting or initiating guideline-recommended hypoglycemic agents for patients admitted with hyperglycemic crisis.Frontiers in medicine · 2025Article
- SQuID (subcutaneous insulin in diabetic ketoacidosis): Clinician acceptability.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Subcutaneous Insulin Aspart Every 4 Hours in the Treatment of COVID-19 Patients With Mild-to-Moderate Diabetic Ketoacidosis: A Case Series.Journal of community hospital internal medicine perspectives · 2025Article
- Hyperglycemic Crises in Adults With Diabetes: A Consensus Report.Diabetes care · 2024Review
- Hyperglycaemic crises in adults with diabetes: a consensus report.Diabetologia · 2024Article
- The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Clinical and biochemical predictors of intensive care unit admission among patients with diabetic ketoacidosis.World journal of diabetes · 2023Article
- Review
- Evaluation of Outcomes Following Hospital-Wide Implementation of a Subcutaneous Insulin Protocol for Diabetic Ketoacidosis.JAMA network open · 2022Article
- Diabetic Ketoacidosis in COVID-19: Unique Concerns and Considerations.The Journal of clinical endocrinology and metabolism · 2020Article
- Diabetic ketoacidosis.Nature reviews. Disease primers · 2020Review
- Diagnosis and management of metabolic acidosis: guidelines from a French expert panel.Annals of intensive care · 2019Review
- Use of lispro insulin for treatment of diabetic ketoacidosis in cats.Journal of feline medicine and surgery · 2019Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo compare the efficacy and safety of rapid acting insulin analog lispro given subcutaneously with that of standard low-dose intravenous regular insulin infusion protocolin patients with mild to moderate diabetic ketoacidosis. MATERIALS AND
methodsIn this prospective, randomized and open trial, 50 consecutive patients of mild to moderate diabetic ketoacidosis were randomly assigned to two groups. The patients in group 1 were treated with intravenous regular insulin infusion and admitted in intensive care unit. The patients in group 2 were treated with subcutaneous insulin lispro 2 hourly and managed in the emergency medical ward. Response to therapy was assessed by duration of treatment and amount of insulin administered until resolution of hyperglycemia and ketoacidosis, total length of hospital stay, and number of hypoglycemic events in the two study groups.
resultsThe baseline clinical and biochemical parameters were similar between the two groups. There were no differences in the mean duration of treatment and amount of insulin required for correction of hyperglycemia and ketoacidosis. There was no mortality and no difference in the length of hospital stay between the two groups. The length of stay and amount of insulin required for correction of hyperglycemia was greater in patients who had infection as the precipitating cause than those with poor compliance. The hypoglycemic events were higher in the regular insulin group (2 vs1) than in the lispro group.
conclusionPatients with uncomplicated diabetic ketoacidosis can be managed in the medical wards with appropriate supervision and careful monitoring. Rapid acting insulin analog lispro is a safe and effective alternative to intravenous regular insulin for this subset of patients.
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Registered trials
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