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[Systematic review with meta-analysis: Subcutaneous insulin glargine coadministration for diabetic ketoacidosis]. / Revisión sistemática con metaanálisis. Coadministración de insulina glargina en el manejo de la cetoacidosis diabética (CAD).
Andrade-Castellanos, Carlos Alberto; Colunga-Lozano, Luis Enrique.
Afiliación
  • Andrade-Castellanos CA; Servicio de Urgencias Adultos, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jal., México.
  • Colunga-Lozano LE; Servicio de Terapia Intensiva, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal., México.
Gac Med Mex ; 152(6): 761-769, 2016.
Article en Es | MEDLINE | ID: mdl-27861474
ABSTRACT

BACKGROUND:

The standard treatment of diabetic ketoacidosis involves intravenous infusion of regular insulin until recovery of the episode this is associated with high costs. Coadministration of insulin glargine from the onset of management may prove beneficial, potentially avoiding rebound hyperglycemia, and hopefully improving the time to resolution of the disease.

METHODS:

We searched MEDLINE, EMBASE, and CENTRAL for randomized controlled trials comparing coadministration of insulin glargine versus standard treatment in patients with diabetic ketoacidosis. To be eligible, studies must assess the efficacy of insulin glargine and report clinically important outcomes. Two reviewers extracted data, assessed risk of bias and summarized strength of evidence using the GRADE approach.

RESULTS:

Four studies (135 participants during hospital follow-up) were included in this review. Low-quality evidence from three trials suggested that subcutaneously administered insulin glargine, in addition to the standard treatment, significantly reduces the time to resolution of diabetic ketoacidosis (MD -4.19 hours; 95% CI -7.81 to 0.57; p = 0.02). There was neutral difference between the two groups regarding length of hospital stay and hypoglycemic episodes.

CONCLUSIONS:

subcutaneously administered insulin glargine, in addition to standard treatment, significantly reduces the time to resolution of diabetic ketoacidosis, with neutral effects on hypoglycemic episodes.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cetoacidosis Diabética / Insulina Glargina / Hipoglucemiantes Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: Es Revista: Gac Med Mex Año: 2016 Tipo del documento: Article
Buscar en Google
Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cetoacidosis Diabética / Insulina Glargina / Hipoglucemiantes Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: Es Revista: Gac Med Mex Año: 2016 Tipo del documento: Article
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