{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T10:13:08Z","timestamp":1788603188278,"version":"build-2803163510"},"reference-count":0,"publisher":"Greater Baltimore Medical Center","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Community Hospital Internal Medicine Perspectives"],"abstract":"<jats:p>This case series evaluates the efficacy and safety of subcutaneous (SC) insulin Aspart administered every four hours for managing mild-to-moderate diabetic ketoacidosis (DKA) in COVID-19 patients, addressing a current evidence gap. We conducted a retrospective review of confirmed COVID-19 patients over 15 years old who developed mild to moderate DKA between July 2020 and October 2021. Insulin Aspart was administered at 0.4 units\/kg SC every 4 hours, reduced to 0.2 units\/kg when blood glucose (BG) decreased to\/dL, and SC basal insulin was initiated at 0.15-0.2 units\/kg at DKA diagnosis. A total of seven patients, with a mean age of 67.4\u00b113.2 years, predominantly female (71.4%), and all with pre-existing type 2 diabetes mellitus, were analyzed. Initial biochemical parameters included BG of 449\u00b1157.3 mg\/dL, HbA1c of 10.6\u00b12.8%, pH of 7.34 (range, 7.26-7.45), beta-hydroxybutyrate of 4.0\u00b11.5 mmol\/L, and bicarbonate of 15.5\u00b12.2 mmol\/L. The time to resolution of hyperglycemia (BG\/dL) and DKA was 8.0\u00b13.1 and was 12.7\u00b15.8 hours, respectively. During DKA resolution, one patient experienced hypoglycemia (47 mg\/dL) and later developed recurrent DKA as COVID-19 infection worsened. Three deaths occurred due to COVID-19-related complications following DKA recovery. While SC insulin Aspart administered every four hours shows promise, careful monitoring for recurrent DKA and septic shock is essential for optimal management.<\/jats:p>","DOI":"10.55729\/2000-9666.1456","type":"journal-article","created":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T05:00:17Z","timestamp":1741496417000},"page":"66-70","source":"Crossref","is-referenced-by-count":0,"title":["Subcutaneous Insulin Aspart Every 4 Hours in the Treatment of COVID-19 Patients With Mild-to-Moderate Diabetic Ketoacidosis: A Case Series"],"prefix":"10.55729","volume":"15","author":[{"given":"Dararat","family":"Chiewchalermsri","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayanin","family":"Wanittansirichok","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chutintorn","family":"Sriphrapradang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"34701","published-online":{"date-parts":[[2025,3,7]]},"container-title":["Journal of Community Hospital Internal Medicine Perspectives"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/scholarlycommons.gbmc.org\/cgi\/viewcontent.cgi?article=1456&amp;context=jchimp","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:56:04Z","timestamp":1788602164000},"score":1,"resource":{"primary":{"URL":"https:\/\/scholarlycommons.gbmc.org\/jchimp\/vol15\/iss2\/11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,7]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,3,7]]}},"URL":"https:\/\/doi.org\/10.55729\/2000-9666.1456","relation":{},"ISSN":["2000-9666"],"issn-type":[{"value":"2000-9666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,7]]}}}