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dc.contributor.authorMaharjan, Jasmine
dc.contributor.authorPandit, Sagar
dc.contributor.authorJohansson, Kjell Arne
dc.contributor.authorKhanal, Pratik
dc.contributor.authorKarmacharya, BirajMan
dc.contributor.authorKaur, Gunjeet
dc.contributor.authorAryal, Krishna
dc.description.abstractAim This systematic review aims to provide evidence on effectiveness of interventions used in emergency care of hypoglycaemia and diabetic ketoacidosis (DKA). Methodology This is a systematic review of randomized controlled trials and analytical studies. We selected studies based on eligibility criteria. The databases Medline, Cochrane library and Embase were searched from their inception till November 2, 2022, using search strategy. We used the term such as “diabetes mellitus”, “treatment”, “hypoglycaemia”, “diabetic ketoacidosis”, “low blood sugar”, “high blood sugar” and Mesh terms like “disease management”, “hypoglycaemia”, “diabetic ketoacidosis”, and “diabetes mellitus” to form search strategy. Results Hypoglycemia: Both 10 % dextrose (D10) and 50 % dextrose (D50) are effective options with similar hospital mortality D10 (4.7 %) and D50 (6.2 %). DKA: Low dose insulin is non-inferior to standard dose with time till resolution of DKA 16.5 (7.2) hours and 17.2 (7.7) hours (p value = 0.73) respectively. In children, subcutaneous insulin was associated with reduced ICU admissions and hospital readmissions (67.8 % to 27.9 %). Plasmalyte (PL) is noninferior to sodium chloride (SC), with ICU length of stay 49 h (IQR 23–72) and 55 h (IQR 41–80) respectively, hyperchloremia was associated with longer in-hospital length of stay and longer time to resolution of DKA. And potassium replacement at < 10 mmol/L was associated with higher mortality (n = 72). Conclusion We conclude either of the 10 % or 50 % dextrose is effective for management of hypoglycaemia. For DKA subcutaneous insulin and intravenous insulin, chloride levels ≤ 109 mEq/L, potassium above 10 mmol/l, IV fluids like Plasmalyte and normal saline are effective.en_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titleEffectiveness of interventions for emergency care of hypoglycaemia and diabetic ketoacidosis: A systematic reviewen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.source.journalDiabetes Research and Clinical Practiceen_US
dc.identifier.citationDiabetes Research and Clinical Practice. 2023, 207, 111078.en_US

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Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal