What is it about?
This retrospective cohort study shows the time to starting intravenous dextrose or oral glucose once a patient's blood glucose level is less than 250mg/dL during the treatment of diabetes-related ketoacidosis (DKA) is associated with hypoglycemia risk. If dextrose or glucose can be started within 30 minutes there is much less risk of hypoglycemia both while the patient is still in DKA and during the entire hospitalization.
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Why is it important?
This study provides the first strong evidence for the expert-recommended intervention of adding dextrose in the treatment of DKA to help prevent hypoglycemia. However, it also shows there is importance with the timing of this intervention.
Perspectives
This article started as a quality improvement project at our hospital system and blossomed into a low-cost and effective intervention to help prevent iatrogenic hypoglycemia in patients being treated for DKA. I also enjoy that it provides evidential support to the time-honored expert recommendation of adding dextrose to the treatment plan of patients with DKA.
Anthony Walls
Ventura County Medical Center
Read the Original
This page is a summary of: Association of Hypoglycemia With the Time to Dextrose in Treatment of Diabetes-Related Ketoacidosis, Clinical Diabetes, September 2025, American Diabetes Association,
DOI: 10.2337/cd25-0019.
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