Effectiveness of glargine insulin on recovery of patients with diabetic ketoacidosis

Abstract

Background: Diabetic Ketoacidosis (DKA) is one of emergency conditions caused by acute hyperglycemia in diabetic patients. The main treatment is injection of rapid-acting Regular insulin. This study was aimed to investigate the effect of Glargine insulin on recovery of patients with DKA. Methods: A randomized clinical trial (RCT) conducted on 40 patients (twenty patients in each group) with DKA. Both groups received standard treatment regimen for DKA. In addition, the experimental group was given 0.4 U/kg of insulin glargine. Results: The mean duration of acidosis correction time and recovery from DKA was 13.77±6.10 hours in the case group and 16.91±6.49 hours in control group (p=0.123). The mean dosage of regular insulin until recovery from DKA was 84.8±45.6 units in the case group and 116.5±91.6 units in control group (p=0.17). Hypokalemia (p=1) and hypoglycemia (p=1) were not different between two groups. In 35% of samples in case group and 51% in controls, the blood sugar (BS) was more than 180 mg/dl for 24 hours after discontinuation of the insulin infusion (p=0.046). The mean duration of hospitalization was 5.1±1.88 days in case and 5.9±2.19 days in control group (p=0.225). Conclusion: Adding insulin Glargine to the standard treatment regimen of DKA significantly reduced rebound hyperglycemia without incurring episodes of hypoglycemia and hypokalemia. It also reduced the average time of recovery from DKA, regular insulin consumption and hospital length, although these changes were not statistically significant. It seems that the non-significant difference be related to the paucity of sample size and close monitoring of patients.