ArticleDiabetic medicine : a journal of the British Diabetic Association2025
Management of diabetic ketoacidosis in adult inpatients: A retrospective analysis of rates of hypoglycaemia with variable-rate and fixed-rate intravenous insulin infusion protocols.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Evaluation of electronic order set implementation in patients with diabetic ketoacidosis: a retrospective cohort study.Therapeutic advances in endocrinology and metabolism · 2026Article
- Management of diabetic ketoacidosis in adult inpatients: A retrospective analysis of rates of hypoglycaemia with variable-rate and fixed-rate intravenous insulin infusion protocols.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo compare variable-rate intravenous insulin infusion (VRIII) to fixed-rate intravenous insulin infusion (FRIII) on the incidence of hypoglycaemia during DKA management. Secondary outcomes were time to resolution of ketosis and hospital length of stay.
methodSingle-centre retrospective cohort study of adults with DKA managed with VRIII protocol and FRIII protocol.
resultsEighty participants were included, 45 treated with VRIII and 35 with FRIII. Hypoglycaemia incidence did not differ, n = 7 (16%) in VRIII and n = 8 (23%) in FRIII (p = 0.565). Of those who developed early hypoglycaemia (<12 h) 88% were in the FRIII cohort versus 29% in VRIII (p = 0.041). Time to resolution of ketosis did not differ between groups (VRIII median 11.5 h [IQR 7-24] vs. FRIII median 9 h [IQR 6-14.5], p = 0.163). The VRIII cohort had both longer hospital length of stay (VRII median 3 days [IQR 1-7] vs. FRIII median 2 days [IQR 1-4], p = 0.049) and longer time on insulin infusion (VRIII median 25 h [IQR 18-41] vs. FRIII median 18 h [IQR 14-28], p = 0.018).
conclusionsThere were similar rates of hypoglycaemia between VRIII and FRIII protocols; however, FRIII was associated with higher rates of early hypoglycaemia. Although time to resolution of ketosis was similar, VRIII was associated with longer hospital length of stay and time on insulin infusion. Further research is needed to determine the optimal insulin infusion regimen.
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