FUTURE DEVELOPMENTS
There are insulin analogues (Aspart and LisPro) that are
ultra-fast acting insulins with shorter half lives than soluble
insulins currently in use. There is no evidence that the use of
such insulins increases the risk of DKA and the management
of patients with diabetes treated with these agents is no
different from that outlined above.
Continuous subcutaneous insulin infusions are commonly
used in continental Europe to treat type I diabetes mellitus
and their use is increasing in the UK. They were initially associated with an increased risk of DKA because of equipment
failure.18 19As the technology has improved this risk has fallen.
Treatment of DKA in patients usually treated with continuous
subcutaneous insulin infusions does not differ from the
conventional approach.