Early Basal Insulin Administration in Adult Diabetic Ketoacidosis Management
Diabetic Ketoacidosis, Type 1 Diabetes, Type 2 Diabetes
About this trial
This is an interventional treatment trial for Diabetic Ketoacidosis
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years old
- Meet DKA definition (BG ≥ 250 mg/dl, Anion Gap > 12 mEq/L, and positive Ketones in serum or urine)
- Having the capacity to sign Informed consent
Exclusion Criteria:
- IV insulin infusion was initiated for more than 4 hours.
- Persistent hypotension (SBP<80 mmHg despite receiving 1000cc normal saline).
- Require Vasopressor
- Acute Coronary Syndrome
- Pregnant
- End-stage renal disease
- Unwilling to consent to participate in the trial
- Currently under police custody
- Transferred from another hospital
- Require emergent surgery
Sites / Locations
- Cleveland Clinic Fairview Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Early Glargine
Standard practice (Late Glargine)
All consecutive adult patients getting admitted to Medical ICU and meet the inclusion criteria and accepted to receive insulin glargine early as per the protocol. They will receive insulin glargine 0.4 unit/kg within 4 hours from initiating the IV Insulin Infusion, as per the Cleveland Clinic DKA protocol.
Retrospective, prespecified and matched sample of consecutive adults who admitted to the same Medical ICU with a diagnosis of DKA in the period between January 1st 2019 till the Institutional Review Board (IRB) approval date and didn't receive basal insulin before Anion Gap closure.