الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication of diabetes mellitus. Diagnosing DKA centers on identifying the classic triad of hyperglycemia, ketosis and acidosis. Hyperglycemia causes fluids and electrolytes to shift from the intracellular to the extracellular space leading to subsequent cellular dehydration and electrolyte abnormalities.
Management focuses on treating the precipitating factors and correcting dehydration, hyperglycemia and electrolyte abnormalities. The mainstay in the treatment of DKA involves the administration of intravenous fluids plus regular insulin via continuous intravenous (IV) infusion or by frequent subcutaneous (SC) or intramuscular (IM) injections.
New analogs of human insulin with a rapid onset of action (aspart , lispro , glulisine) have become available and may represent alternatives to the use of regular insulin in the treatment of DKA.
The aim of the work was to compare the use of subcutaneously rapidly-acting insulin analog (insulin glulisine) at an hourly interval to intravenous infusion of rapidly-acting insulin analog (insulin glulisine) in patients with mild to moderate diabetic ketoacidosis (DKA).
This study was conducted on 30 patients with uncomplicated mild to moderate DKA of both gender. They were selected from those admitted to the Diabetes Care Unit in Alexandria Main University Hospital.
On the basis of management, 15 patients were recovered by insulin glulisine given subcutaneously every hour and the other 15 by insulin glulisine given by continuous intravenous infusion.
All of the following variables were monitored till reaching the goals: random blood glucose/hour, arterial pH/4 hours, monitoring of acidosis by serum bicarbonate concentration through the ABG (to assess correction of metabolic acidosis), serum ketone bodies /4 hours.