低剂量胰岛素输注与标准剂量治疗儿童糖尿病酮症酸中毒的Meta分析

Low dose insulin infusion versus the standard dose in children with diabetic ketoacidosis: a meta-analysis.

作者信息

Belal Mohamed Mohamed, Khalefa Basma Badrawy, Rabea Eslam Mohammed, Aly Yassin Mazen Negmeldin, Bashir Mohamed Nabih, Abd El-Hameed Malak Mohamed, Elkoumi Omar, Saad Saad Mohamed, Saad Loubna Mohamed, Elkasaby Mohamed Hamouda

机构信息

Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Medical Research Group of Egypt (MRGE), Cairo, Egypt.

出版信息

Future Sci OA. 2024 May 14;10(1):FSO956. doi: 10.2144/fsoa-2023-0137. eCollection 2024.

DOI:10.2144/fsoa-2023-0137

PMID:38827803

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11140676/

Abstract

This systematic review aims to consolidate findings from current clinical trials that compare the effectiveness of insulin infusion at 0.05 IU/kg/h versus 0.1 IU/kg/h in managing pediatric diabetic ketoacidosis. We searched several databases, including PubMed, Embase, Scopus, Cochrane Central and Web of Science. Our primary outcomes were time to reach blood glucose ≤250 mg/dl and time to resolution of acidosis. Secondary outcomes included rate of blood glucose decrease per hour, incidence of hypoglycemia, hypokalemia, treatment failure, and cerebral edema. The present study establishes that a low insulin dose exhibits comparable efficacy to the standard dosage for managing pediatric patients suffering from diabetic ketoacidosis, with a lower incidence of complications.

摘要

本系统评价旨在整合当前临床试验的结果，这些试验比较了以0.05 IU/kg/h与0.1 IU/kg/h的胰岛素输注速率治疗小儿糖尿病酮症酸中毒的有效性。我们检索了多个数据库，包括PubMed、Embase、Scopus、Cochrane Central和科学网。我们的主要结局指标为血糖降至≤250 mg/dl的时间和酸中毒缓解的时间。次要结局指标包括每小时血糖下降速率、低血糖、低钾血症、治疗失败及脑水肿的发生率。本研究证实，低剂量胰岛素在治疗小儿糖尿病酮症酸中毒患者时疗效与标准剂量相当，且并发症发生率更低。