Sub-Cutaneous Insulin in Hyperglycaemic Emergencies
Sub-Cutaneous Insulin in Hyperglycaemic Emergencies
Hyperglycaemic emergencies are associated with significant mortality (mortality in Diabetic
 Ketoacidosis 0.65 - 3.3% and in HyperOsmolar Non-Ketotic Coma 12 -17%). To reduce morbidity
 and mortality, prompt intervention and coma and close monitoring are essential. The study is
 designed to investigate whether a simple intervention with a long acting insulin can improve
 resolution of acidosis and hyperglycaemia, prevent recurrence of ketoacidosis and shorten
 hospital stay.
This is a randomised trial concerning patients presenting in A & E with a diabetic emergency,
 either a Diabetic Ketoacidosis (DKA) or a Hyperosmolar Non-Ketotic Coma (HONC). Once informed
 consent has been given, each patient will receive standard intravenous treatment. They will
 also receive a daily sub-cutaneous bolus of either a long-acting insulin or a placebo.

 Blood will be taken at regular intervals to analyse the rate of fall of glucose and
 normalisation of blood pH.
Inclusion Criteria:

 -  Patients presenting with a diabetic emergency aged 18 and above.

 Exclusion Criteria:

 -  Patients who do not speak English and need a translator.

 -  Patients under the age of 18 years.

 -  Patients who are unable to give their consent and who do not have a relative present
 wiling to give assent.