Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 50
- Neutral
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerInsulin TherapyType 2 Diabetes (T2D)
Research Summary
Analyzed using Evidence Intelligence™
Early insulin degludec with IV insulin infusion speeds DKA resolution by 3.25 hours without increasing hypoglycaemia risk
Last updated May 13, 2026
Key finding
A randomized trial in 80 adults with diabetic ketoacidosis found that early subcutaneous insulin degludec (0.3 units/kg within 3 hours) plus standard IV insulin infusion resolved DKA 3.25 hours faster than IV insulin alone, with no increase in hypoglycaemia or hypokalaemia.
This study tested whether giving a shot of long-acting insulin (degludec) early, along with the standard IV insulin drip, could help resolve diabetic ketoacidosis faster. In 80 adults, the combination resolved DKA about 3 hours sooner and led to better blood sugar levels 3 days later, without raising the risk of low blood sugar or low potassium.
Quick read
Study at a glance
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
Randomized Controlled Trials (RCTs)
Follow-up
Short-Term (≤3 mo)
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
A randomized trial in 80 adults with diabetic ketoacidosis found that early subcutaneous insulin degludec (0.3 units/kg within 3 hours) plus standard IV insulin infusion resolved DKA 3.25 hours faster than IV insulin alone, with no increase in hypoglycaemia or hypokalaemia.
Published in
Journal Reference
Publication details and source links for this paper.
Thammakosol K, Jantarapootirat M, Traiwanatham S, Sriphrapradang C. Early insulin degludec with continuous intravenous insulin infusion in the management of diabetic ketoacidosis: A randomized controlled trial. Diabetes Obes Metab. 2025;27(12):7020-7029. doi:10.1111/dom.70101
Main Effects
↓ DKA resolution time reduced by 3.25 hours with early degludec (p=0.039)
↓ Capillary blood glucose at 72h lower by 26 mg/dL with degludec (p=0.012)
→ Hypoglycaemia and hypokalaemia rates similar between groups (not significant)
Evidence network
How this study fits
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Evidence Context
This study contributes evidence to Insulin degludec and All-cause mortality, Blood glucose, HbA1c, and 1 more.
This study contributes evidence to
Primary intervention
Insulin degludec
Primary outcomes
- All-cause mortality
- Blood glucose
- HbA1c
Primary intervention
Primary outcomes
Evidence relationships
Intervention and outcome relationships this study adds to the evidence network.
4
Evidence pairs
4
Relationships
5
Evidence topics
contributes_evidence
Editorial context
Why this study matters
See why this paper is useful beyond its individual results.
Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
Moderate contributionModerate confidenceNetwork score: 54
5
Related topics
4
Evidence pairs
505
Related studies
High relevance in at least one topic
Why it is useful
- Contributes to 4 evidence relationships
- Uses a randomized study design signal
- Linked to 5 direct semantic evidence topics
Topic contributions
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Insulin Therapies and Fasting Glucose
Related evidence
Evidence relationship
Insulin Therapies and HbA1c
Save evidence
Evidence relationship
Insulin Therapies and Cardiovascular Outcomes
Save evidence
Core evidence
Study findings
The primary outcomes reported in this study.
Evidence Intelligence™
- EvidenceScore™
- Moderate
- Score 69 · Based on 2 studies
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 2 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Library
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Evidence Suggest
- Early insulin degludec plus standard IVII safely accelerates DKA resolution compared to IVII alone
- Blood glucose control was better at 72h after transition to subcutaneous insulin with early degludec
- No increase in hypoglycaemia or hypokalaemia despite faster metabolic correction
Who this applies to
Adults with diabetic ketoacidosis (both type 1 and type 2 diabetes) in hospital settings. Results are most relevant to patients with classic DKA (plasma glucose ≥250 mg/dL) without euglycemic DKA, haemodynamic instability, or pregnancy.
Keep in Mind
The study was open-label, which could bias some decisions. The comparison used glargine U-100 in the control group after DKA resolution, which differs from degludec's pharmacokinetic profile. Euglycemic DKA patients were excluded. Ketone monitoring was not used for resolution assessment per 2009 ADA criteria.
Between the Lines
- Open-label design may influence clinician decisions on IVII timing and discharge
- No routine ketone monitoring for DKA resolution assessment (used pH/bicarbonate/anion gap)
- Euglycemic DKA patients excluded, limiting generalizability to that population
- Single-country study in Thailand may not fully generalize to other healthcare settings
Evidence Library
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Connected Evidence
Explore related studies, evidence collections, and research questions.
Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Insulin Therapies and Fasting Glucose, Insulin Therapies and Cardiovascular Outcomes.
Related evidence relationships
Explore in Evidence ExplorerThis study contributes to the evidence on the following intervention-outcome relationships.
Medications
Insulin Therapies → Fasting Glucose
Medications
Evidence Intelligence™
- EvidenceScore™
- Moderate
- Score 69 · Based on 2 studies
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 2 studies
View evidenceMedications
Insulin Therapies → Cardiovascular Outcomes
Medications
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 50
- Neutral
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
View evidenceIncluded in these evidence collections
Curated evidence collections and hubs this study is part of.
Fasting Glucose Evidence Hub
All studies measuring Fasting Glucose
2 studies
outcome_hubMeasures Fasting Glucose as a key outcome.
Insulin Therapies Evidence Hub
All studies on Insulin Therapies
2 studies
intervention_hubContributes to Insulin Therapies evidence base.
Cardiovascular Outcomes Evidence Hub
All studies measuring Cardiovascular Outcomes
1 studies
outcome_hubMeasures Cardiovascular Outcomes as a key outcome.
Explore more in Evidence Explorer
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All studies on Insulin degludec and Blood glucose
Intervention: Insulin degludecOutcome: Blood glucose
2 results
All studies on Insulin degludec and All-cause mortality
Intervention: Insulin degludecOutcome: All-cause mortality
1 results
All studies on Insulin degludec
Intervention: Insulin degludec
2 results
All studies measuring Blood glucose
Outcome: Blood glucose
2 results
All studies measuring All-cause mortality
Outcome: All-cause mortality
1 results
Questions answered by this study
Generated from the study's connected evidence using Evidence Intelligence™.
Does Insulin Therapies improve fasting glucose?
Strong Evidence
Insulin Therapies appears to improve Fasting Glucose.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
Blood glucose
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 5 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does Insulin Therapies improve HbA1c?
Strong Evidence
Insulin Therapies may improve HbA1c.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
- 1
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on 7 supporting studies with generally consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does Insulin Therapies improve cardiovascular outcomes?
Emerging Evidence
Current evidence does not show a clear benefit of Insulin Therapies for Cardiovascular Outcomes.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
All-cause mortality
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
- Only one supporting study is available.
- Consistency cannot yet be determined.
- Population details are unavailable.
Does Insulin Therapies affect hypoglycemia?
Emerging Evidence
Insulin Therapies appears to improve Hypoglycemia.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Hypoglycemia events
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
- Only one supporting study is available.
- Consistency cannot yet be determined.
- Population details are unavailable.
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