Subcutaneous rapid-acting insulin analogs vs. intravenous regular insulin for the treatment of diabetic ketoacidosis. Literature review
Keywords:
diabetic cetoacidosis; insulin; fast-acting insulin analogs; effectiveness; security.Abstract
The increase in cases of diabetes mellitus generates saturation of the Intensive Care Units (ICU) due to Diabetic Ketoacidosis and increases hospital morbidity in Ecuador. Rapid-acting insulin analogs have become the subject of investigation as a potential alternative to the use of intravenous infusion of regular insulin with the aim of achieving a decrease in ICU admissions in patients with uncomplicated diabetic ketoacidosis. The objective is to analyze the available scientific evidence on the efficacy and safety of subcutaneous rapid-acting insulin analogs compared with intravenous regular insulin for the treatment of diabetic ketoacidosis. An extended review was carried out from 2012 to 2022 in high-impact databases. Eighteen articles were cited that met the inclusion criteria. The studies showed that fast-acting insulin analogs have a lower relative risk of hypoglycemia with statistically significant evidence, in terms of resolution time and length of hospital stay there were no statistically significant differences between both treatments, there were fewer admissions to the ICU and with This results in a lower cost with treatment with subcutaneous insulin analogs. As part of the conclusions, it can be stated that fast-acting insulin analogs are a good therapeutic option to consider in action protocols for the management of uncomplicated diabetic ketoacidosis.
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