ArticlePediatric diabetes2017
Glargine co-administration with intravenous insulin in pediatric diabetic ketoacidosis is safe and facilitates transition to a subcutaneous regimen.
Article in Pediatric diabetes, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Early vs. late initiation of long-acting basal insulin during IV insulin in pediatric diabetic ketoacidosis: a GRADE-assessed systematic review and meta-analysis.European journal of pediatrics · 2025Pooled it
- 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
- 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Retrospective Evaluation of Early Glargine Administration in Adults With Diabetic Ketoacidosis.Cureus · 2025Article
- Assessment of the use of long-acting insulin in management of diabetic ketoacidosis in pediatric patients: a randomized controlled trial.Annals of pediatric endocrinology & metabolism · 2025Article
- A Narrative Review on Diabetic Ketoacidosis in Children.Current pediatric reviews · 2025Review
- 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- Guidelines for the Management of Complications of Diabetes in Saudi Arabia Using Delphi Technique for Consensus Among National Experts.Clinics and practice · 2024Article
- Retrospective Comparison of Early Versus Late Initiation of Long-Acting Insulin in Critically Ill Pediatric Patients in Diabetic Ketoacidosis.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Hyperglycemic Crises in Adults With Diabetes: A Consensus Report.Diabetes care · 2024Review
- Hyperglycaemic crises in adults with diabetes: a consensus report.Diabetologia · 2024Article
- Management of diabetic ketoacidosis in children: Does early insulin glargine help improve outcomes?Journal of diabetes · 2024Article
- 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- Evaluation of the Effects of Incorporating Long-Acting Subcutaneous Insulin Into the Standard Treatment Protocol for Diabetic Ketoacidosis in Children.International journal of endocrinology and metabolism · 2024Article
- Evaluation of Early Insulin Glargine Administration in the Treatment of Pediatric Diabetic Ketoacidosis.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2023Article
- 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2023.Diabetes care · 2023Review
- Effect of the Concomitant Use of Subcutaneous Basal Insulin and Intravenous Insulin Infusion in the Treatment of Severe Hyperglycemic Patients.Endocrinology and metabolism (Seoul, Korea) · 2022Article
- Diabetic Ketoacidosis Updates: Titratable Insulin Infusions and Long-Acting Insulin Early.Critical care research and practice · 2021Article
- Management of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes Mellitus.Paediatric drugs · 2020Review
- Clinical Use of Degludec in Children and Adolescents with T1D: A Narrative Review with Fictionalized Case Reports.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundDiabetes ketoacidosis (DKA) is a common presentation and complication of type 1 diabetes (T1D). While intravenous insulin is typically used to treat acute metabolic abnormalities, the transition from intravenous to subcutaneous treatment can present a challenge. We hypothesize that co-administration of glargine, a subcutaneous long-acting insulin analog, during insulin infusion may facilitate a flexible and safe transition from intravenous to subcutaneous therapy.
objectiveTo determine if the practice of administering subcutaneous glargine during intravenous insulin is associated with an increased risk of hypoglycemia, hypokalemia, or other complications in children with DKA.
methodsRetrospective chart review of patients aged 2 to 21 years, presenting to our center with DKA between April 2012 and June 2014. Patients were divided into two groups: those co-administered subcutaneous glargine with intravenous insulin for over 4 hours (G+); and patients with less than 2 hours of overlap (G-).
resultsWe reviewed 149 DKA admissions (55 G+, 94 G-) from 129 unique patients. There was a similar incidence of hypoglycemia between groups (25% G+ vs 20% G-, P = 0.46). Hypokalemia (<3.5 mmol/L) occurred more frequently in the G+ group (OR = 3.4, 95% CI 1.7-7.0, P = 0.001). Cerebral edema occurred in 2/55 (3.6%) of the G- group and none of the G+ subjects.
conclusionCo-administration of glargine early in the course of DKA treatment is well tolerated and convenient for discharge planning; however, this approach is associated with an increased risk of hypokalemia.
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Registered trials
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