ArticleAnnals of pediatric endocrinology & metabolism2025
Assessment of the use of long-acting insulin in management of diabetic ketoacidosis in pediatric patients: a randomized controlled trial.
Article in Annals of pediatric endocrinology & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Early versus late initiation of long-acting insulin in paediatric and adult diabetic ketoacidosis: A systematic review and meta-analysis of randomised control trials.Diabetes, obesity & metabolism · 2026Pooled it
- 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
- Efficacy and safety of reduced-dose insulin infusion in pediatric diabetic ketoacidosis: a randomized clinical trial.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2026Article
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Authors and funding
5 authors.
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Abstract
purposeWe evaluated the effectiveness of early start of long-acting insulin during management of diabetic ketoacidosis (DKA) in pediatric patients.
methodsPatients with DKA were randomly assigned to receive either a traditional DKA management protocol or concurrent administration of subcutaneous (SC) long-acting insulin alongside intravenous insulin during DKA treatment. The primary outcomes were duration of insulin infusion and adverse effects of the intervention, mainly hypoglycemia and hypokalemia.
resultsFor this study, 100 pediatric patients with DKA were enrolled, 50 in each group (group I received the conventional DKA management and group II received conventional DKA management plus SC long-acting insulin once daily). Patients in group II showed a significant reduction in both duration and dose of insulin infusion compared to group I, with a median (interquartile range) of 68.5 hours (45.00-88.25 hours) versus 72 hours (70.25-95.5 hours) (P=0.0001) and an insulin dose of 3.48±1.00 units/kg versus 4.04±1.17 units/kg (P=0.016), respectively. Concurrent administration of SC long-acting insulin with intravenous insulin during DKA treatment was associated with a decreased risk of hypoglycemia (number of hypoglycemia events: group I, 22 events; group II, 12 events, P=0.029), with no increased risk of hypokalemia compared to the control group (number of hypokalemia events: group I, 12 events; group II, 19 events, P=0.147).
conclusionThe current study showed that coadministration of SC long-acting insulin in addition to the usual insulin infusion during DKA management in the pediatric population can lead to a shorter duration of insulin infusion. In addition, this approach is not associated with increased risk of hypoglycemia or hypokalemia. Moreover, coadministration of long-acting insulin may be associated with a decreased incidence of hypoglycemia.
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