Higher-Than-Conventional Subcutaneous Regular Insulin Doses in Diabetic Ketoacidosis in Children and Adolescents
Objective: To evaluate the effect of initial insulin dosage on glycemic control in the first 48 hours of subcutaneous regular insulin therapy after resolution of diabetic ketoacidosis (DKA). Methods: Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6.0-12.0) year...
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| Veröffentlicht in: | Journal of clinical research in pediatric endocrinology 2017-06, Vol.9 (2), p.132-137 |
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| container_title | Journal of clinical research in pediatric endocrinology |
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| creator | Bag, Ozlem Tunc, Selma Nalbantoglu, Ozlem Ecevit, Cigdem Ozturk, Aysel Ozkan, Behzat Demir, Korcan |
| description | Objective: To evaluate the effect of initial insulin dosage on glycemic control in the first 48 hours of subcutaneous regular insulin therapy after resolution of diabetic ketoacidosis (DKA). Methods: Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6.0-12.0) years, Male/Female: 44/32] were reviewed. The patients were designated into two groups according to distribution of starting doses of subcutaneous insulin. Group 1 (n=28) received a median dose of 1.45 U/kg/day (1.41-1.5) and group 2 (n=48) a median dose of 0.96 U/kg/day (0.89-1). Clinical and laboratory data were analyzed. Results: Median, minimum, and maximum blood glucose levels of Group 1 in the first 48 hours of treatment were significantly lower than that of Group 2 [213 (171-242) vs. 255 (222-316), p= |
| doi_str_mv | 10.4274/jcrpe.3925 |
| format | Article |
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Methods: Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6.0-12.0) years, Male/Female: 44/32] were reviewed. The patients were designated into two groups according to distribution of starting doses of subcutaneous insulin. Group 1 (n=28) received a median dose of 1.45 U/kg/day (1.41-1.5) and group 2 (n=48) a median dose of 0.96 U/kg/day (0.89-1). Clinical and laboratory data were analyzed. Results: Median, minimum, and maximum blood glucose levels of Group 1 in the first 48 hours of treatment were significantly lower than that of Group 2 [213 (171-242) vs. 255 (222-316), p=<0.001; 102 (85-151) vs. 129 (105-199), p=0.004; and 335 (290-365) vs. 375 (341-438), p=0.001, respectively]. The number of patients who experienced hypoglycemia (<70 mg/dL) were similar [Group 1, 5 (17.9%) vs. Group 2, 4 (8.3%), p=0.276] and none had severe hypoglycemia. In Group 1, the ratio of blood glucose levels within the target range (100-200 mg/dL) were higher (37.5% vs. 12.5%) and the number of results >200 mg/dL were lower (50% vs. 81.3%) compared to Group 2 (p=0.001 and p<0.001, respectively). Conclusion: After resolution of DKA, a higher initial dose of 1.4-1.5 U/kg/day regular insulin is associated with better glycemic control in children and adolescents without an increase in risk of hypoglycemia. Keywords: Type 1 diabetes mellitus, regular insulin, initial doses, children, adolescent</description><identifier>ISSN: 1308-5727</identifier><identifier>EISSN: 1308-5735</identifier><identifier>DOI: 10.4274/jcrpe.3925</identifier><language>eng</language><publisher>Galenos Yayinevi Tic. Ltd</publisher><subject>Analysis ; Care and treatment ; Complications and side effects ; Diabetic ketoacidosis ; Dosage and administration ; Drug therapy ; Insulin ; Juvenile diabetes ; Patient outcomes ; Tıp ; Treatment outcome</subject><ispartof>Journal of clinical research in pediatric endocrinology, 2017-06, Vol.9 (2), p.132-137</ispartof><rights>COPYRIGHT 2017 Galenos Yayinevi Tic. Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-369327b206050aa89368dad2c06872f534221bb8a81fc5bdbb1c94e7c023056b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids></links><search><contributor>Darendeliler,Fatma Feyza</contributor><creatorcontrib>Bag, Ozlem</creatorcontrib><creatorcontrib>Tunc, Selma</creatorcontrib><creatorcontrib>Nalbantoglu, Ozlem</creatorcontrib><creatorcontrib>Ecevit, Cigdem</creatorcontrib><creatorcontrib>Ozturk, Aysel</creatorcontrib><creatorcontrib>Ozkan, Behzat</creatorcontrib><creatorcontrib>Demir, Korcan</creatorcontrib><title>Higher-Than-Conventional Subcutaneous Regular Insulin Doses in Diabetic Ketoacidosis in Children and Adolescents</title><title>Journal of clinical research in pediatric endocrinology</title><description>Objective: To evaluate the effect of initial insulin dosage on glycemic control in the first 48 hours of subcutaneous regular insulin therapy after resolution of diabetic ketoacidosis (DKA). Methods: Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6.0-12.0) years, Male/Female: 44/32] were reviewed. The patients were designated into two groups according to distribution of starting doses of subcutaneous insulin. Group 1 (n=28) received a median dose of 1.45 U/kg/day (1.41-1.5) and group 2 (n=48) a median dose of 0.96 U/kg/day (0.89-1). Clinical and laboratory data were analyzed. Results: Median, minimum, and maximum blood glucose levels of Group 1 in the first 48 hours of treatment were significantly lower than that of Group 2 [213 (171-242) vs. 255 (222-316), p=<0.001; 102 (85-151) vs. 129 (105-199), p=0.004; and 335 (290-365) vs. 375 (341-438), p=0.001, respectively]. The number of patients who experienced hypoglycemia (<70 mg/dL) were similar [Group 1, 5 (17.9%) vs. Group 2, 4 (8.3%), p=0.276] and none had severe hypoglycemia. In Group 1, the ratio of blood glucose levels within the target range (100-200 mg/dL) were higher (37.5% vs. 12.5%) and the number of results >200 mg/dL were lower (50% vs. 81.3%) compared to Group 2 (p=0.001 and p<0.001, respectively). Conclusion: After resolution of DKA, a higher initial dose of 1.4-1.5 U/kg/day regular insulin is associated with better glycemic control in children and adolescents without an increase in risk of hypoglycemia. Keywords: Type 1 diabetes mellitus, regular insulin, initial doses, children, adolescent</description><subject>Analysis</subject><subject>Care and treatment</subject><subject>Complications and side effects</subject><subject>Diabetic ketoacidosis</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Insulin</subject><subject>Juvenile diabetes</subject><subject>Patient outcomes</subject><subject>Tıp</subject><subject>Treatment outcome</subject><issn>1308-5727</issn><issn>1308-5735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNptUU1LAzEQXUTBUnvxFyx4EISt2WSzH8dlW22xIGg9h3zMtilpUpJdwX_vthVBcOYww8x7jxleFN2maJrhInvcSX-AKakwvYhGKUFlQgtCL397XFxHkxB2aIgsKxClo-iw0Jst-GS95TZpnP0E22lnuYnfeyH7jltwfYjfYNMb7uOlDb3RNp65ACE-NpoL6LSMX6BzXGrlgj4tmq02yoONuVVxrZyBIAftcBNdtdwEmPzUcfTxNF83i2T1-rxs6lUiSZ53CckrgguBUY4o4rysSF4qrrBEeVnglpIM41SIkpdpK6lQQqSyyqCQCBNEc0HG0f1ZVyvgxtnhamA71_vht8CWs3m9YhThkgzIuzNyww0wbVvXeS73OkhWU1JkhKA0HVDTf1BDKthr6Sy0epj_ITycCdK7EDy07OD1nvsvliJ29Iud_GJHv8g3PNSH7Q</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Bag, Ozlem</creator><creator>Tunc, Selma</creator><creator>Nalbantoglu, Ozlem</creator><creator>Ecevit, Cigdem</creator><creator>Ozturk, Aysel</creator><creator>Ozkan, Behzat</creator><creator>Demir, Korcan</creator><general>Galenos Yayinevi Tic. Ltd</general><general>Türk Pediatrik Endokrinoloji ve Diyabet Derneği</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IEBAR</scope></search><sort><creationdate>20170601</creationdate><title>Higher-Than-Conventional Subcutaneous Regular Insulin Doses in Diabetic Ketoacidosis in Children and Adolescents</title><author>Bag, Ozlem ; Tunc, Selma ; Nalbantoglu, Ozlem ; Ecevit, Cigdem ; Ozturk, Aysel ; Ozkan, Behzat ; Demir, Korcan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-369327b206050aa89368dad2c06872f534221bb8a81fc5bdbb1c94e7c023056b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis</topic><topic>Care and treatment</topic><topic>Complications and side effects</topic><topic>Diabetic ketoacidosis</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Insulin</topic><topic>Juvenile diabetes</topic><topic>Patient outcomes</topic><topic>Tıp</topic><topic>Treatment outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bag, Ozlem</creatorcontrib><creatorcontrib>Tunc, Selma</creatorcontrib><creatorcontrib>Nalbantoglu, Ozlem</creatorcontrib><creatorcontrib>Ecevit, Cigdem</creatorcontrib><creatorcontrib>Ozturk, Aysel</creatorcontrib><creatorcontrib>Ozkan, Behzat</creatorcontrib><creatorcontrib>Demir, Korcan</creatorcontrib><collection>CrossRef</collection><collection>Idealonline online kütüphane - Journals</collection><jtitle>Journal of clinical research in pediatric endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bag, Ozlem</au><au>Tunc, Selma</au><au>Nalbantoglu, Ozlem</au><au>Ecevit, Cigdem</au><au>Ozturk, Aysel</au><au>Ozkan, Behzat</au><au>Demir, Korcan</au><au>Darendeliler,Fatma Feyza</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher-Than-Conventional Subcutaneous Regular Insulin Doses in Diabetic Ketoacidosis in Children and Adolescents</atitle><jtitle>Journal of clinical research in pediatric endocrinology</jtitle><date>2017-06-01</date><risdate>2017</risdate><volume>9</volume><issue>2</issue><spage>132</spage><epage>137</epage><pages>132-137</pages><issn>1308-5727</issn><eissn>1308-5735</eissn><abstract>Objective: To evaluate the effect of initial insulin dosage on glycemic control in the first 48 hours of subcutaneous regular insulin therapy after resolution of diabetic ketoacidosis (DKA). Methods: Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6.0-12.0) years, Male/Female: 44/32] were reviewed. The patients were designated into two groups according to distribution of starting doses of subcutaneous insulin. Group 1 (n=28) received a median dose of 1.45 U/kg/day (1.41-1.5) and group 2 (n=48) a median dose of 0.96 U/kg/day (0.89-1). Clinical and laboratory data were analyzed. Results: Median, minimum, and maximum blood glucose levels of Group 1 in the first 48 hours of treatment were significantly lower than that of Group 2 [213 (171-242) vs. 255 (222-316), p=<0.001; 102 (85-151) vs. 129 (105-199), p=0.004; and 335 (290-365) vs. 375 (341-438), p=0.001, respectively]. The number of patients who experienced hypoglycemia (<70 mg/dL) were similar [Group 1, 5 (17.9%) vs. Group 2, 4 (8.3%), p=0.276] and none had severe hypoglycemia. In Group 1, the ratio of blood glucose levels within the target range (100-200 mg/dL) were higher (37.5% vs. 12.5%) and the number of results >200 mg/dL were lower (50% vs. 81.3%) compared to Group 2 (p=0.001 and p<0.001, respectively). Conclusion: After resolution of DKA, a higher initial dose of 1.4-1.5 U/kg/day regular insulin is associated with better glycemic control in children and adolescents without an increase in risk of hypoglycemia. Keywords: Type 1 diabetes mellitus, regular insulin, initial doses, children, adolescent</abstract><pub>Galenos Yayinevi Tic. Ltd</pub><doi>10.4274/jcrpe.3925</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Care and treatment Complications and side effects Diabetic ketoacidosis Dosage and administration Drug therapy Insulin Juvenile diabetes Patient outcomes Tıp Treatment outcome |
| title | Higher-Than-Conventional Subcutaneous Regular Insulin Doses in Diabetic Ketoacidosis in Children and Adolescents |
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