Evaluation of the Use of Short Acting Insulin in the Management of Mild to Moderate Diabetic Ketoacidosis: A Simple Literature Review

Abstract

Background: Diabetes mellitus (DM) is one of the most common chronic diseases. It can cause a lot of complications such as retinopathy, nephropathy, and neuropathy. Patients with DM are at risk of having acute attacks of hyperglycemia and ketoacidosis as well as hypoglycemia. ketoacidosis management is accomplished by the administration of intravenous infusion of regular insulin. Intravenous insulin infusion requires ICU admission in most of institutions, which will increase the hospitals cost (infusion pumps, IV access, nurses). Accordingly, we have done a literature study to determine whether intermittent subcutaneous use of these rapid-acting analogs might be as effective as intravenous insulin infusions in treating uncomplicated diabetic ketoacidosis. Objective: In this study, we aimed at evaluating the effect of using short acting insulin in the management of mild to moderate DKA. Methods: PubMed database was used for articles selection, and the following keys were used in the mesh (Insulin Lispro[Mesh]) AND (Diabetic Ketoacidosis/drug therapy[Mesh] OR Diabetic Ketoacidosis/therapy[Mesh]) A total of 13 articles were found, with further restriction by PubMed filters, and reviewing the articles titles and abstracts the final results were 5 articles. Conclusion: Subcutaneous (S/C) Aspart insulin every 2 hours can be as safe and effective as SC Lispro insulin every one hour and as continuous IV insulin infusion in the treatment of mild to moderate uncomplicated cases of DKA. There was no significant statistical difference among the 3 approaches regarding the efficacy, and the mean duration of the treatment period. SC aspart insulin every 2 hours is more economical and fairer type intervention.