Early subcutaneous basal insulin with intravenous insulin infusion for diabetic ketoacidosis management: A systematic review and meta‐analysis of randomised controlled trials
An erratum to this article was published (Diabetes Obes Metab, Mar 2026 ↗)
Pooled result · Time to DKA resolutionResult — go to the resultMD −4.02 h 95% CI −5.52 to −2.52Authors' conclusion
Early SC basal insulin in combination with IVII significantly accelerates DKA resolution and reduces total IVII requirements, without increasing the risk of adverse events, including hypoglycemia or hypokalemia.
Study context
- Population
- Patients with Diabetic Ketoacidosis (DKA) in Randomised Controlled Trials (RCTs) (PubMed, Embase, Scopus, Cochrane Library, to 6 September 2025)
- Participants
- 468 patients8 RCTs
- Comparison
- Early subcutaneous (SC) basal insulin plus intravenous insulin infusion (IVII) vs IVII alone
- Early SC basal insulin + IVIIn = 256
- IVII alonen = 212reference
- Outcome
- Time to DKA resolution
Methodological detailsone-stage individual participant data meta-analysis where available
- One-stage individual participant data meta-analysis where available
Pooled result
As reported in the abstract
MD
−4.02 h
95% CI −5.52 to −2.52
P < 0.001
Early SC basal insulin + IVIIvs IVII alone
MD −4.02 h (95% CI −5.52 to −2.52); P < 0.001
Further pooled results
| Outcome | MD (units) (95% CI) | P value | |
|---|---|---|---|
| Total intravenous insulin dose until DKA resolution | −19.2 (−28.99 to −9.26) | P < 0.001 | |
| −40−20020Difference, units (linear scale) |
Rebound hyperglycemia, LOS, in-hospital mortality
- No significant differences between groups for rebound hyperglycemia, LOS or in-hospital mortality
Safety
Safety outcomes (hypoglycemia, hypokalemia)
- No significant differences between groups for safety outcomes
Original publication
Early subcutaneous basal insulin with intravenous insulin infusion for diabetic ketoacidosis management: A systematic review and meta‐analysis of randomised controlled trials. Diabetes Obes Metab. Published 10 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →