Early Administration of Long-acting Insulin Treatment of Diabetic Ketoacidosis in Pediatric Type 1 Diabetes
Early Administration of Long-acting Insulin Treatment of Diabetic Ketoacidosis in Pediatric Type 1 Diabetes
The management goals of diabetic ketoacidosis (DKA) in the pediatric type 1 diabetes (T1DM)
 population are fluid and electrolyte repletion, insulin administration, and correction of
 acidosis in order to stabilize the patient. Traditionally, a rapid-acting insulin IV infusion
 is begun immediately and continued until the acidosis is corrected and hyperglycemia
 normalized. Once the acidosis is corrected, patients are able to be transitioned to a
 subcutaneous insulin regimen.

 The role that a subcutaneous long-acting insulin such as glargine has in the acute treatment
 of DKA has not been extensively studied. While giving glargine during the treatment of DKA is
 becoming more common place, few studies have examined the potential risks and benefits of its
 use. This study will investigate the effects of early administration of glargine during DKA
 in patients with newly diagnosed TIDM.

 The design of this study is a prospective, double-blind study of children ages 2-21 who are
 admitted to the hospital in DKA with a diagnosis of T1DM. The control group will receive all
 traditional methods of treatment for DKA, including a placebo subcutaneous injection. The
 study group will receive the same treatment, but will be supplemented with a subcutaneous
 glargine injection.
Inclusion Criteria:

 -  T1DM

 -  Hyperglycemia >200 mg/dl

 -  Bicarbonate ≤ 15 mmol/L

 -  pH < 7.3

 -  Ketonemia

 -  Ketonuria

 -  Glucosuria

 -  Admission to PICU (Pediatric Intensive Care Unit)

 -  Ages 1-21 years

 Exclusion Criteria:

 -  Patients who received glargine within the last 24 hours

 -  Patients with sepsis