Abstract / Summary
Pediatric diabetic ketoacidosis (DKA) is life-threatening; traditional IV insulin risks hypoglycemia and electrolyte issues. We evaluated the efficacy and safety of continuous subcutaneous insulin infusion (CSII) combined with electrolyte supplementation in DKA.
Sixty-six patients were randomly assigned to the study group (CSII + electrolyte supplementation) or control group (intravenous insulin infusion + electrolyte supplementation). Overall efficacy, time to pH normalization, target blood glucose achievement, urine ketone clearance, levels of BUN, creatinine, potassium, FPG, 2hPG and sodium, inflammatory markers, acid-base balance indicators, and adverse reactions were compared.
Study group had higher overall efficacy (χ2 = 5.121), shorter time to pH normalization, target blood glucose achievement, and urine ketone clearance (t = 8.023, 7.712, 7.438), lower BUN, creatinine, FPG, 2hPG, sodium, CRP, TNF-α, and IL-6 levels (t = 8.893, 15.816, 5.865, 12.267, 4.542, 3.626, 2.615, 5.746), higher serum potassium, CO₂CP, and blood pH levels (t = 9.737, 4.220, 17.78), and lower blood lactate levels (t = 6.922) and adverse reaction rates (χ2 = 4.243) than the control group (all P < 0.05).
 CSII with electrolyte supplementation improves pediatric DKA treatment outcomes by regulating blood glucose and electrolytes, alleviating inflammation and acidosis, and reducing adverse reactions during treatment.
• Pediatric diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus. • Traditional intravenous insulin infusion is the standard treatment but carries risks of hypoglycemia, hypokalemia, and other electrolyte disturbances. • Electrolyte supplementation is routinely used alongside insulin therapy to correct dehydration and metabolic imbalances in DKA.
• This study provides clinical evidence that continuous subcutaneous insulin infusion (CSII) combined with electrolyte supplementation is more effective than conventional intravenous insulin therapy in pediatric DKA. • CSII-based regimen achieved faster pH normalization, blood glucose control, and urine ketone clearance, with better improvements in renal function, inflammatory markers, and acid-base balance. • The CSII group also showed lower rates of adverse reactions, suggesting that this approach may offer a safer and more efficient alternative for managing pediatric DKA.