Kitabchi AE et al. - Areas of future research include prospective randomized studies: (a) to establish the efficacy of bicarbonate therapy in DKA for a pH < 6.9; (b) to establish the need for a bolus insulin dose in the initial therapy of DKA; (c) to determine the pathophysiologic mechanisms for the absence of ketosis in HHS; (d) to investigate the reason for elevated pro-inflammatory cytokines and cardiovascular risk factors; and (e) to evaluate the efficacy and cost benefit of using subcutaneous regular insulin versus a more expensive insulin analog on the general ward for the treatment of DKA.
