Abstract Background and Objective Diabetic ketoacidosis (DKA) is a serious and increasingly common complication of diabetes with high morbidity and mortality. Early use of long-acting basal insulin alongside IV insulin may improve outcomes. This systematic review and meta-analysis aims to evaluate the efficacy and safety of co-administering insulin glargine with IV insulin in DKA management. Methods A literature search was conducted to identify relevant studies. Key outcomes included time to DKA resolution, hospital stay length, and hypoglycemia risk. RCT quality was assessed using the Cochrane risk of bias tool, and retrospective studies with the Newcastle-Ottawa Scale. Standardized mean differences with 95% CIs were used for continuous outcomes, and risk ratios for dichotomous outcomes. A random-effects model was applied using RevMan (version 5.4). Results A total of six studies were included in this meta-analysis comprising of a cumulative sample size of 302 patients with 127 in the intervention group and 175 in the control group, the pooled results showed that co-administration of insulin glargine resulted in significantly reduced time to DKA resolution, along with decreased length of hospital stay as compared to the group receiving IV infusion alone, while the rate of hypoglycemia and hypokalemia were comparable between the two groups. Conclusion When treating DKA, a combination of IV insulin infusion and long-acting basal insulin glargine may shorten hospital stays and speed up the time to resolution without increasing the risk of hypoglycemia or hypokalemia.
Altamimi et al. (Tue,) studied this question.