Effects of long-acting somatostatin analogue (Sandostatin) on manifest diabetic ketoacidosis.
Insulin deficiency and counterregulatory hormone excess are the basic process in the development of diabetic ketoacidosis (DKA). Somatostatin, which suppresses the secretion of glucagon and growth hormone, has been known to attenuate the rate of gluconeogesis and ketogenesis in insulin-dependent diabetes mellitus patients. However, the therapeutic efficacy of somatostatin has not been approved to be practical in the treatment of manifest DKA. To examine the additive effect of octreotide, the synthetic long-acting somatostatin analogue SMS 201-995, to conventional treatment of manifest DKA, we compared the correction time of acidosis, ketonuria, and hyperglycemia of patients treated with an intravenous infusion of low-dose insulin (4 units per hour) plus subcutaneous injection of octreotide (50 microg every 6 hours) by low-dose insulin alone. The correction time for hyperglycemia and acidosis did not show any difference between groups (p = 0.089, p = 0.82). However, the time for disappearance of ketonuria of the octreotide-treated group (38.0 +/- 32.0 h) was reduced significantly compared to other group (68.3 +/- 26.0 h) (p = 0.048). These results indicated that the addition of octreotide to conventional treatment of DKA might improve the correction of ketosis, but would not allow more rapid control of acidosis and hyperglycemia in manifest DKA.
Yun
Y S
YS
Department of Endocrinology and Metabolism, Diabetes Center, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Lee
H C
HC
Park
C S
CS
Chang
K H
KH
Cho
C H
CH
Song
Y D
YD
Lim
S K
SK
Kim
K R
KR
Huh
K B
KB
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007657:Ketone Bodies / Q000652:urine; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D013997:Time Factors
D001786:Blood Glucose; D002096:C-Peptide; D006728:Hormones; D007004:Hypoglycemic Agents; D007328:Insulin; D007657:Ketone Bodies; D015282:Octreotide