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Is subcutaneous insulin as effective and safe as intravenous insulin in the treatment of mild to moderate diabetic ketoacidosis (DKA) in children and adolescents?
A 7-year-old girl comes to the emergency room with a short history of thirst, polyuria and weight loss. She looks mildly dehydrated at clinical examination. Her blood glucose is 25 mmol/L. There is a mild to moderate DKA with a pH of 7.20, pCO2 of 4.5 kPa and a base excess of −9.
A non-compliant 15-year-old adolescent, known to have diabetes type 1 for 7 years calls his paediatrician because he is not feeling well. His self-measured blood glucose is 33 mmol/L and his blood β-hydroxybutyrate is 3.5 mmol/L. The paediatrician advises him to come to the emergency room (ER). There, his blood gas shows a pH of 7.25, pCO2 of 5 kPa and a base excess of −7. Except for looking pale, his clinical examination is normal.
Structured clinical question
Is subcutaneous insulin therapy as effective and safe as intravenous insulin to treat mild to moderate DKA in children and adolescents with …
Contributors We, EM and DM, hereby declare that we both contributed to the review of the literature and the writing of the manuscript.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.