Low dose insulin infusion versus the standard dose in children with diabetic ketoacidosis: a meta-analysis

• Published in: Future science OA Vol. 10; no. 1; p. FSO956
• Main Authors: Belal, Mohamed Mohamed, Khalefa, Basma Badrawy, Rabea, Eslam Mohammed, Aly Yassin, Mazen Negmeldin, Bashir, Mohamed Nabih, Abd El-Hameed, Malak Mohamed, Elkoumi, Omar, Saad, Saad Mohamed, Saad, Loubna Mohamed, Elkasaby, Mohamed Hamouda
• Format: Journal Article
• Language: English
• Published: England Future Science Ltd 2024
• Subjects: diabetic ketoacidosis; DKA; insulin; low dose; pediatrics; standard dose; DKA; standard dose; diabetic ketoacidosis; insulin; low dose; pediatrics
• ISSN: 2056-5623; 2056-5623
• DOI: 10.2144/fsoa-2023-0137

This systematic review aims to consolidate findings from current clinical trials that compare the effectiveness of insulin infusion at 0.05 IU/kg/h versus 0.1 IU/kg/h in managing pediatric diabetic ketoacidosis. We searched several databases, including PubMed, Embase, Scopus, Cochrane Central and Web of Science. Our primary outcomes were time to reach blood glucose ≤250 mg/dl and time to resolution of acidosis. Secondary outcomes included rate of blood glucose decrease per hour, incidence of hypoglycemia, hypokalemia, treatment failure, and cerebral edema. The present study establishes that a low insulin dose exhibits comparable efficacy to the standard dosage for managing pediatric patients suffering from diabetic ketoacidosis, with a lower incidence of complications. When kids with type 1 Diabetes (T1DM) face a serious complication called Diabetic Ketoacidosis (DKA), it becomes a life-threatening situation. This condition, responsible for significant mortality, involves high blood sugar, ketone buildup and acidity. Our study delves into a critical aspect of DKA treatment-finding the right insulin dose. By pooling the studies on this point, we discovered that using a lower insulin dose is just as effective as the standard dose in managing DKA in children, with fewer complications. This insight is crucial for improving the care and outcomes for young patients dealing with this challenging condition.