Evaluation of the Effects of Incorporating Long-Acting Subcutaneous Insulin Into the Standard Treatment Protocol for Diabetic Ketoacidosis in Children

Abstract

Background: Despite the progress made in the treatment of type 1 diabetes, the incidence of diabetic ketoacidosis (DKA) in children is still increasing, and its management requires hospitalization in the pediatric intensive care unit (PICU). It is important to find a new and low-risk treatment method to shorten the recovery time from DKA. Objectives: This study aimed to evaluate the effectiveness and safety of integrating two different types of long-acting subcutaneous insulin into the standard treatment for DKA in children. Methods: The study was conducted in the PICU, and comprehensive monitoring was performed throughout the process. Patients aged between 2 and 15 years were divided into three groups: two intervention groups receiving the addition of two types of long-acting insulin, Detemir and Glargine, to the standard treatment, and a control group. Each group consisted of 36 individuals. The impact of the intervention on the recovery time from DKA and the potential complications were investigated in all three groups. Results: The analysis of the results revealed a significant difference in the duration of exiting the acute phase among the groups. Additionally, the post-hoc test demonstrated that the recovery time for ketoacidosis in the Detemir arm was significantly shorter than in the standard arm (P = 0.008). However, it is important to note that there were no significant differences in the occurrence of common complications among the three study groups. Conclusions: Based on the findings, it appears that incorporating specific types of long-acting subcutaneous insulin into the standard treatment of DKA in children leads to a reduction in the resolution time of the acute phase of ketoacidosis. Importantly, this approach does not introduce additional complications. Consequently, it has the potential to optimize resource allocation and enhance patient care by freeing up beds in the PICU.