Diabetes Research Today is a free monthly online journal that collates and summarizes the latest research about Diabetes, including details on insulin, type i, type ii, diet, treatment, prevention.

Mandatory protocol for treating adult patients with diabetic ketoacidosis decreases intensive care unit and hospital lengths of stay: results of a nonrandomized trial.

Bull SV, Douglas IS, Foster M, Albert RK

University of Colorado Health Sciences Center, Denver, CO, USA.

OBJECTIVE: To determine the effect of a mandatory protocol for treating diabetic ketoacidosis. DESIGN: Chart review of patients treated before and after protocol implementation. SETTING: University-affiliated U.S. public teaching hospital. PATIENTS: A total of 241 consecutive nonpregnant patients >18 yrs old admitted to a medical intensive care unit for diabetic ketoacidosis between January 2000 and January 2005. INTERVENTION: Implementation of a mandatory treatment protocol in May 2003. MEASUREMENTS: Intensive care unit and hospital lengths of stay, time to correction of anion gap and ketone clearance, and hypoglycemic episodes. RESULTS: Before protocol implementation, the mean +/- sd intensive care unit and hospital lengths of stay were 44 +/- 28 hrs and 91 +/- 73 hrs, respectively. After implementation, intensive care unit and hospital lengths of stay decreased 23% and 30%, to 34 +/- 18 hrs and 64 +/- 41 hrs, respectively (both p < .007). Time to anion gap closure and ketone clearance also decreased (both p < .05). No difference in the number of hypoglycemic episodes was observed. CONCLUSION: Implementing a mandatory protocol for treating adult patients with diabetic ketoacidosis decreases intensive care and hospital lengths of stay and time to anion gap closure and ketone clearance, without increasing the rate of hypoglycemia.

Published 1 January 2007 in Crit Care Med, 35(1): 41-6.
Full-text of this article is available online (may require subscription).

© 2004-2008 Diabetes Research Today. All Rights Reserved.