Recommendation ID
NG18/5
Question

Optimal dosage of intravenous insulin for managing diabetic ketoacidosis in children and young people:- What is the optimal dosage of intravenous insulin for managing diabetic ketoacidosis (DKA) in children and young people?

Any explanatory notes
(if applicable)

Why this is important:- The evidence reviewed for the guideline did not allow evaluation of the comparative effectiveness and safety of specific dosages of intravenous insulin, such as 0.025, 0.05 and 0.1 units/kg/hour. The only relevant studies conducted to date have been small retrospective cohort studies with fewer than 100 participants. A large, multi-centre randomised controlled trial is needed to undertake a comparative study of different dosages. This is because DKA is relatively  uncommon and cerebral oedema (a potential adverse consequence of DKA) is rare, and there is a concern that larger dosages are associated with an increased risk of cerebral oedema. Important outcomes include rate of DKA resolution, incidence of hypoglycaemia and incidence of cerebral oedema.


Source guidance details

Comes from guidance
Diabetes (type 1 and type 2) in children and young people: diagnosis and management
Number
NG18
Date issued
August 2015

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No