Evidence mapPaperPMID 40900206Full record

ReviewCurrent diabetes reports2025

Developing a Protocol for Management of Euglycemic Diabetic Ketoacidosis.

Zulma Cardona, Jared G Friedman, Nevin Kamal, Diana J Oakes, Amisha Wallia, Grazia Aleppo, Sophia Brown, Courtney T Makowski, Kyle Ritter, Emily D Szmuilowicz

Abstract readReview
In one paragraph

Review in Current diabetes reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Euglycemic Diabetic Ketoacidosis Treatment Protocol With Increased Dextrose Supplementation to Prevent Hypoglycemia.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Article
  4. Review
  5. Euglycemic Diabetic Ketoacidosis: Clinical Suspicion and Diagnosis.Clinical medicine insights. Endocrinology and diabetes · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Zulma CardonaDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.
Jared G FriedmanDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.
Nevin KamalDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.
Diana J OakesDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.
Amisha WalliaDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.
Grazia AleppoDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.
Sophia BrownNorthwestern Memorial Hospital, Chicago, IL, USA.
Courtney T MakowskiNorthwestern Memorial Hospital, Chicago, IL, USA.
Kyle RitterNorthwestern Memorial Hospital, Chicago, IL, USA.
Emily D SzmuilowiczDivision of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA. edszmuilowicz@northwestern.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewEuglycemic diabetic ketoacidosis (euDKA) has been described since the 1970s, however the incidence appears to be increasing in association with the increased use of sodium-glucose cotransporter 2 inhibitor (SGLT2i) medications. Traditional hospital-based DKA protocols in which an insulin infusion is adjusted based on glucose levels are not effective in euDKA due to the presence of euglycemia which limits the capacity for insulin administration. This review was completed to review the data on euDKA and introduce a protocol for targeted management of this condition. RECENT

findingsData comparing euDKA outcomes to traditional hyperglycemia DKA demonstrate longer hospital length of stay and mean time to anion gap closure in euDKA based on current DKA management standards. Furthermore, the increase in prescribing SGLT2i medications thereby increases the risk of euDKA. At present, there are no reported protocols specific for euDKA and it is not directly addressed in the most recent guidelines issued by Endocrinology specialty societies. We created a protocol within our hospital intensive care unit to standardize treatment of euDKA using fixed insulin infusion and titration of dextrose-containing fluids. The protocol has been approved by our hospital regulatory committees and is currently being utilized in intensive care units. Future studies should review ongoing safety and efficacy of protocol use in various hospital settings.

Indexed as

Diabetic KetoacidosisBlood GlucoseClinical ProtocolsHumansInsulinSodium-Glucose Transporter 2 InhibitorsBlood GlucoseInsulinSodium-Glucose Transporter 2 InhibitorsDKAEuglycemic diabetic ketoacidosisHospital protocolInsulin infusionSGLT2 inhibitor

Identifiers

PMID40900206
PMCPMC12408655

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.