{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:51:05Z","timestamp":1791478265189,"version":"4.3.4"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2026-0329_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although intravenous (IV) insulin remains the standard treatment for diabetic ketoacidosis (DKA), subcutaneous (SC) insulin has been suggested as an alternative for uncomplicated DKA. We compared treatment duration, hospital length of stay (LOS) and adverse events in children with mild DKA treated with a SC insulin protocol to those of children treated with an IV insulin protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0329_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed medical records of children with mild DKA admitted to a children\u2019s hospital before and after introduction of a SC insulin protocol. Children treated with the SC protocol received daily basal insulin along with rapid-acting insulin every 4\u202fh. We compared outcomes for children treated with SC insulin to those of children treated with IV insulin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0329_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty two children were treated with SC insulin and 29 with IV insulin. In the SC group vs. the IV group, mean protocol duration (17.1\u00a0\u00b1\u00a08.6 vs. 13.5\u00a0\u00b1\u00a04.6\u202fh) and LOS (34.9\u00a0\u00b1\u00a016.7 vs. 37.8\u00a0\u00b1\u00a023.6\u202fh) were not significantly different (p=0.07 and p=0.63, respectively). There were no significant differences in adverse events frequency between groups. No child treated with SC insulin required a change to IV insulin treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0329_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment of children with uncomplicated mild DKA with SC insulin is safe and effective without prolonging\u00a0LOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2026-0329","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:57:47Z","timestamp":1788857867000},"page":"1046-1050","source":"Crossref","is-referenced-by-count":0,"title":["Subcutaneous insulin treatment for mild pediatric diabetic ketoacidosis: an evaluation of treatment duration and length of stay"],"prefix":"10.1515","volume":"39","author":[{"given":"Shelby","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Section of Endocrinology , University of California Davis School of Medicine , 2516 Stockton Blvd , Sacramento , CA , 95817 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Glaser","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Section of Endocrinology , University of California Davis School of Medicine , 2516 Stockton Blvd , Sacramento , CA , 95817 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Loomba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Section of Endocrinology , University of California Davis School of Medicine , 2516 Stockton Blvd , Sacramento , CA , 95817 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Schulmeister","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Section of Endocrinology , University of California Davis School of Medicine , 2516 Stockton Blvd , Sacramento , CA , 95817 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026100815572192006_j_jpem-2026-0329_ref_001","doi-asserted-by":"crossref","unstructured":"Glaser, N, Fritsch, M, Priyambada, L, Rewers, A, Cherubini, V, Estrada, S, et al.. ISPAD clinical practice consensus guidelines 2022: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes 2022;23:835\u201356. https:\/\/doi.org\/10.1111\/pedi.13406.","DOI":"10.1111\/pedi.13406"},{"key":"2026100815572192006_j_jpem-2026-0329_ref_002","doi-asserted-by":"crossref","unstructured":"Priyambada, L, Wolfsdorf, JI, Brink, SJ, Fritsch, M, Codner, E, Donaghue, KC, et al.. ISPAD clinical practice consensus guideline: diabetic ketoacidosis in the time of COVID-19 and resource-limited settings-role of subcutaneous insulin. Pediatr Diabetes 2020;21:1394\u2013402. https:\/\/doi.org\/10.1111\/pedi.13118.","DOI":"10.1111\/pedi.13118"},{"key":"2026100815572192006_j_jpem-2026-0329_ref_003","doi-asserted-by":"crossref","unstructured":"Everett, EM, Copeland, TP, Moin, T, Wisk, LE. National trends in pediatric admissions for diabetic ketoacidosis, 2006\u20132016. J\u00a0Clin Endocrinol Metabol 2021;106:2343\u201354. https:\/\/doi.org\/10.1210\/clinem\/dgab287.","DOI":"10.1210\/clinem\/dgab287"},{"key":"2026100815572192006_j_jpem-2026-0329_ref_004","doi-asserted-by":"crossref","unstructured":"Desai, D, Mehta, D, Mathias, P, Menon, G, Schubart, UK. Health care utilization and burden of diabetic ketoacidosis in the U.S. over the past decade: a nationwide analysis. Diabetes Care 2018;41:1631\u20138. https:\/\/doi.org\/10.2337\/dc17-1379.","DOI":"10.2337\/dc17-1379"},{"key":"2026100815572192006_j_jpem-2026-0329_ref_005","doi-asserted-by":"crossref","unstructured":"Razavi, Z, Maher, S, Fredmal, J. Comparison of subcutaneous insulin aspart and intravenous regular insulin for the treatment of mild and moderate diabetic ketoacidosis in pediatric patients. 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