Abstract
Objectives We aimed to compare the efficacy of oral versus intravenous (IV) fluid therapy in
correcting dehydration in diabetic ketoacidosis (DKA) when pH was ≥ 7.25 and Glasgow
coma scale (GCS) score was ≥12. We also compared the time to resolution of DKA.
Subjects Children aged ≤18 years with DKA were included in the study. In our pilot study,
40 children were enrolled from June 2018 to April 2019 and divided into two groups
after achieving pH ≥ 7.25 and GCS score ≥ 12.
Materials and Methods This was an open-label, parallel-arm, randomized control trial conducted in the pediatric
intensive care unit of a tertiary referral hospital in North India. The IV group (control
group) received treatment as per the standard protocol, whereas the oral group (trial
group) received only oral fluids; IV fluid was withheld for 48 hours. Dehydration
was clinically assessed on admission and after 48 hours, and the proportion of children
achieving correction of dehydration was compared. Biochemical parameters were measured
over time, and the time taken for resolution was compared between groups.
Results Both groups achieved successful correction of dehydration. No significant difference
was observed in the time taken from randomization to complete resolution of DKA. Hyperchloremia
improved significantly earlier in the oral group after randomization.
Conclusion Early institution of oral rehydration strategy after achieving pH ≥ 7.25 and GCS
score ≥ 12 was effective in correcting dehydration at a rate comparable to standard
IV rehydration. Hyperchloremia was observed to resolve earlier in patients that received
oral rehydration therapy.
Keywords
diabetic ketoacidosis - oral rehydration therapy - fluid therapy - intravenous fluid
- dehydration
