Meglumine sodium succinate for intensive therapy of diabetic ketoacidosis in school-aged children

Optimal infusion therapy in children with diabetic ketoacidosis (DKA) is still unclear. There is insufficient evidence to support any crystalloid solution in children. Objective. To evaluate the efficacy of 1.5% solution of meglumine sodium succinate (MSS) in children with moderate-to-severe DKA. Material and methods. An observational study included patients aged 7—17 years with moderate-to-severe DKA. All patients (n=60) received standard infusion therapy after admission to intensive care unit (ICU). Participants in the main group (n=30) additionally received 1.5% MSS at a dose of 10 ml/kg/day. Primary endpoints were time to DKA regression and proportion of patients with compensation after 24 and 48 hours. Logistic and linear regression methods were used. Results. DKA regressed in 90% of patients in the MSS group and 60% in the control group within 24 hours (p<0.001). After 48 hours, DKA regressed in all patients of both groups. In the main group, time to DKA regression was 16.5 hours, ICU-stay — 20.0 hours, time to recovery of consciousness — 4.0 hours. In the control group, these values were 24.0, 29.2 and 8.0 hours, respectively (p<0.001). Conclusion. We observed superiority of MSS for infusion therapy in school-age children with moderate-to-severe DKA. Faster normalization of clinical and laboratory parameters in the MSS group reduced ICU-stay.