P DKA X WHEN TO SWITCH TO SC INSULIN X NO NAUSEA X VpH7.3 OR BIC OVR 15

Is serum bicarbonate better than venous pH to predict recovery in diabetic ketoacidosis? (J Pediatr Endocrinol Metab. Dec 2018. [Epub ahead of print]) Resolution of acidosis is monitored closely in diabetic ketoacidosis following which intravenous (IV) insulin is transited to subcutaneous (SC) insulin. This study evaluated if measurement of serum bicarbonate (target ≥15 mmol/L) was better than venous pH (≥7.3) to shorten duration of insulin infusion and pediatric intensive care unit (PICU) therapies. Retrospective review of 274 case records of children was performed. Approximately equal number had transited from IV to SC insulin based on serum bicarbonate (n=132) and venous pH (n=142). The duration of insulin infusion and PICU stay were significantly shorter in bicarbonate group. The adverse events recorded between both groups remained similar.