Key result
Adding NPH insulin fails to reduce overall DKA resolution time but shortens severe cases.
Why the study?
While adding glargine to regular insulin infusion has shown promising results in shortening DKA resolution, whether adding Neutral Protamine Hagedorn (NPH) insulin to continuous insulin infusion hastens resolution remained unassessed.
Does the early addition of subcutaneous NPH insulin to continuous insulin infusion reduce the time to resolution of DKA in adult patients?
Population
50 adult participants with DKA
Comparison
Subcutaneous NPH insulin plus continuous insulin infusion vs standard of care
Design
Open-label randomised controlled trial
Authors
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Early NPH addition may shorten severe DKA resolution time; supports larger RCTs before changing practice.
RCT (n=50)
Open-label
Block randomisation with varying block sizes of 2, 4, and 6
No
Does the early addition of subcutaneous NPH insulin to continuous insulin infusion reduce the time to resolution of DKA in adult patients?
Absolute Event Rate: 18% vs 34%
p-value: p=0.15
The early addition of subcutaneous NPH insulin to continuous insulin infusion significantly shortens the time to resolution of severe DKA and delays rebound hyperglycemia in a resource-limited setting.
Wyawahare et al. (2025) conducted an RCT in Diabetic ketoacidosis (n=50). Neutral Protamine Hagedorn (NPH) insulin vs. Standard of care (continuous insulin infusion) was evaluated on Time to resolution of DKA (hours) (p=0.15). NPH insulin added to continuous insulin infusion did not significantly reduce overall time to resolution of diabetic ketoacidosis (18 vs 34 hours, p=0.15), but shortened it in severe DKA.
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