Do you manage mild-to-moderate diabetic ketoacidosis with a subcutaneous rapid-acting insulin protocol rather than an IV insulin infusion?

Yes, SC rapid-acting insulin can be used in the mild cases of DKA, provided that dehydration is not severe enough to affect insulin absorption. Small, frequent doses every hour may replace the IV insulin in mild cases. A good tip is to start correcting fluid loss in the first or two hours before starting SC insulin.

SC use of the fast-acting insulin analog (lispro) has been tried in pediatric DKA (0.15 U/kg q2h). The results were shown to be comparable to IV insulin, but ketosis took 6 additional hours to resolve. Such technically simplified methods may be cost-effective and may preclude admissions to intensive care units in patients with mild cases. Use of subcutaneous insulin analog (aspart) has been shown to be effective as well in adult...