>Gaceta Médica de México
>Year 2016, Issue 6
Andrade-Castellanos CA, Colunga-Lozano LE
Systematic review with meta-analysis: Subcutaneous insulin glargine coadministration for diabetic ketoacidosis
Gac Med Mex 2016; 152 (6)
PDF: 118.35 Kb.
Background: The standard treatment of diabetic ketoacidosis involves intravenous infusion of regular insulin until recovery
of the episode: this is associated with high costs. Coadministration of insulin glargine from the onset of management may
prove beneficial, potentially avoiding rebound hyperglycemia, and hopefully improving the time to resolution of the disease.
Methods: We searched MEDLINE, EMBASE, and CENTRAL for randomized controlled trials comparing coadministration of
insulin glargine versus standard treatment in patients with diabetic ketoacidosis. To be eligible, studies must assess the
efficacy of insulin glargine and report clinically important outcomes. Two reviewers extracted data, assessed risk of bias and
summarized strength of evidence using the GRADE approach. Results: Four studies (135 participants during hospital
follow-up) were included in this review. Low-quality evidence from three trials suggested that subcutaneously administered
insulin glargine, in addition to the standard treatment, significantly reduces the time to resolution of diabetic ketoacidosis (MD –4.19 hours; 95% CI: –7.81 to 0.57; p = 0.02). There was neutral difference between the two groups regarding length of
hospital stay and hypoglycemic episodes. Conclusions: subcutaneously administered insulin glargine, in addition to standard
treatment, significantly reduces the time to resolution of diabetic ketoacidosis, with neutral effects on hypoglycemic episodes.
||Diabetic coma, Diabetic ketoacidosis, Diabetes mellitus, Insulin glargine, Long-acting insulin.
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>Gaceta Médica de México
>Year 2016, Issue 6