Stephanie Baddock, Lisa Raven, Gimhani Abeygunasekara, Mirelle Roche, Carolyn Petersons
{"title":"成人住院患者糖尿病酮症酸中毒的管理：可变速率和固定速率静脉胰岛素输注方案低血糖发生率的回顾性分析。","authors":"Stephanie Baddock, Lisa Raven, Gimhani Abeygunasekara, Mirelle Roche, Carolyn Petersons","doi":"10.1111/dme.70063","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To 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.</p><p><strong>Method: </strong>Single-centre retrospective cohort study of adults with DKA managed with VRIII protocol and FRIII protocol.</p><p><strong>Results: </strong>Eighty 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).</p><p><strong>Conclusions: </strong>There 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.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70063"},"PeriodicalIF":3.2000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management of diabetic ketoacidosis in adult inpatients: A retrospective analysis of rates of hypoglycaemia with variable-rate and fixed-rate intravenous insulin infusion protocols.\",\"authors\":\"Stephanie Baddock, Lisa Raven, Gimhani Abeygunasekara, Mirelle Roche, Carolyn Petersons\",\"doi\":\"10.1111/dme.70063\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To 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.</p><p><strong>Method: </strong>Single-centre retrospective cohort study of adults with DKA managed with VRIII protocol and FRIII protocol.</p><p><strong>Results: </strong>Eighty 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).</p><p><strong>Conclusions: </strong>There 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.</p>\",\"PeriodicalId\":11251,\"journal\":{\"name\":\"Diabetic Medicine\",\"volume\":\" \",\"pages\":\"e70063\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetic Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/dme.70063\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dme.70063","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Management of diabetic ketoacidosis in adult inpatients: A retrospective analysis of rates of hypoglycaemia with variable-rate and fixed-rate intravenous insulin infusion protocols.
Aims: To 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.
Method: Single-centre retrospective cohort study of adults with DKA managed with VRIII protocol and FRIII protocol.
Results: Eighty 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).
Conclusions: There 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.
期刊介绍：
Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions.
The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed.
We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services.
Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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