Clinical Factors Associated with Failure of Insulin Transition in Adults with Diabetic Ketoacidosis: A Retrospective Cohort Study
Authors' conclusion
The FT group had worse clinical outcomes and utilized more health care resources than the ST group. Key factors such as higher BMI, more comorbidities, higher post-transition glucose and lower bicarbonate levels are associated with transition failure.
Study context
- Population
- Patients aged ≥18 years admitted with diabetic ketoacidosis (DKA)
- Participants
- 493 patients
- Exposure
- Failed vs successful transition from IV to subcutaneous insulin
- Outcome
- Predictors of transition failure (multivariable logistic regression)
Main finding
As reported in the abstract
Higher body mass index (BMI)
OR: 1.05
P = .029
Presence of comorbidities
OR: 2.53
P = .034
Lower bicarbonate during transition
OR: 0.88
P = .004
Higher anion gap
OR: 1.11
P = .049
Observational data: associations, not effects.
Further findings
Transition outcome
In-hospital mortality · higher with FT
P < 0.001
ICU LOS · longer with FT
P < 0.001
| Outcome | FT | ST | P value |
|---|---|---|---|
| Hospital chargeGreater with FT | mean $224,362 ± 317 628 | mean $75 226 ± 128 042 | P < 0.001 |
Patient characteristics
- Failed transition (FT) had higher mean BMI and more comorbidities than successful transition (ST)
Original publication
Clinical Factors Associated with Failure of Insulin Transition in Adults with Diabetic Ketoacidosis: A Retrospective Cohort Study. Endocr Pract. Published 17 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →