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Two-bag on par with one-bag system in adults with diabetic ketoacidosis

21 Feb 2021

The efficacy and safety of the two-bag (TB) system are comparable to those of the one-bag (OB) system in adults with diabetic ketoacidosis (DKA), results of a study have shown. Both approaches can be considered in adult DKA patients.

The authors performed a retrospective review at an academic medical centre to determine if the TB system, which utilizes two intravenous (IV) fluid bags, one containing sodium chloride and the other containing sodium chloride and dextrose, is a safe and effective alternative to the tradition OB system.

Adults with DKA were included if they were treated with either the OB or the TB system. Time to anion gap closure was the primary outcome. Secondary ones were as follows: duration of insulin infusion, time to serum bicarbonate correction, number of continuous IV fluid orders, intensive care unit (ICU) and hospital length of stay (LOS), and rates of hypoglycaemia and hypokalaemia.

In total, 122 patients met the eligibility criteria. Of these, 68 were treated with the OB system and 54 with the TB system. No between-group differences were observed in time to anion gap closure, duration of insulin infusion, ICU LOS, or hospital LOS.

On the other hand, the OB group had shorter time to bicarbonate correction (13.5 hours, interquartile range [IQR], 7–29) than the TB group (25 hours, IQR, 11–50; p=0.03). No differences were seen in the rates of hypoglycaemia or hypokalaemia between the two groups.

“DKA is a serious complication of diabetes mellitus,” according to the authors.

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Most Read Articles
01 Apr 2021
Migraine and headache are common ailments of people living in the modern era. Dr Jon Marshall of The Singapore Headache and Migraine Clinic shares his insights with Pearl Toh on how to manage migraine and headache using non-pharmaceutical strategies, with a focus on the manual medicine approach.
Pearl Toh, 19 Mar 2021
Dupilumab effectively prevents severe asthma exacerbations and improves lung function in patients with difficult-to-treat type 2 asthma, according to a post hoc analysis of the LIBERTY ASTHMA QUEST study presented at AAAAI 2021.
Elaine Soliven, 17 Mar 2021
Treatment with an intranasal budesonide aqueous spray led to significantly reduced nasal symptoms in adults with rhinitis exposed to high levels of airborne pollution, according to a study presented at AAAAI 2021.