The 2025 annual scientific assembly of the American College of Emergency Physicians (ACEP) just wrapped up in Salt Lake City, Utah. From September 7 through September 10, ACEP25 was four days packed with educational courses, engaging networking social events, and the latest technologies and products designed to benefit emergency medicine professionals.

Each year, the ACEP Research Forum presents hundreds of abstracts as part of the overall ACEP conference. The forum represents a thoughtful showcase of thought-provoking and educational abstracts from ACEP members. In 2025, more than 550 abstracts were accepted by ACEP for presentation at the conference. Below, you will find the abstracts that are related to diabetic ketoacidosis, a life-threatening complication caused by a buildup of ketone. 

Diabetic Ketoacidosis Abstracts Presented at ACEP25

Glargine as an Adjunct to Standard Therapy for Managing Diabetic Ketoacidosis: A Randomized Trial

  • Objectives: Comparing the duration of diabetic ketoacidosis resolution among patients receiving glargine with standard intravenous insulation versus standard IV insulin alone, along with comparing the duration of emergency and hospital stay, total insulin requirement, and complications between the groups.
  • Conclusion: Researchers suggested that glargine co-administered early with IV insulin is associated with early diabetic ketoacidosis resolution, shortened emergency stay, and infrequent rebound hyperglycemia, with no significant elevation in hyperglycemic or hypokalemic episodes than standard IV insulin alone.
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Balanced Crystalloid Solution in Diabetic Ketoacidosis Does Not Improve Treatment Time

  • Objectives: This study was designed to evaluate the impact of a protocol encouraging the use of lactated Ringer solution (LR) on diabetic ketoacidosis-related outcomes, including insulin discontinuation, diabetic ketoacidosis resolution, and hospital-based metrics.
  • Conclusion: Researchers found no notable improvement in diabetic ketoacidosis resolution or hospital-free days with LR compared to normal saline. A slightly prolonged time to insulin discontinuation was noted when LR was predominantly used.
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Hypokalemia Rates Do Not Improve with Balanced Crystalloid Solution in Diabetic Ketoacidosis

  • Objective: The study’s objective was to evaluate the impact of a multifaceted implementation program promoting the use of balanced crystalloid solutions in diabetic ketoacidosis on hypokalemia rates.
  • Conclusion: There was not a significant reduction in hypokalemia rates observed from the implementation of a protocol favoring lactated Ringer over normal saline in the treatment of diabetic ketoacidosis. Researchers suggest that, despite theorized benefits, lactated Ringer does not provide a measurable advantage in preventing hypokalemia in patients with diabetic ketoacidosis.
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Impact of the Revised Diabetic Ketoacidosis Diagnostic Criteria on Patient Classification

  • Description: Researchers evaluated the impact of the revised American Diabetes Association (ADA) diabetic ketoacidosis criteria on identifications to inform the potential effect of the new definition on emergency department diabetic ketoacidosis treatment protocols and study inclusion.
  • Conclusion: Researchers identified a subgroup of patients with diabetic ketoacidosis from a larger parent study using the previous definition and the new ADA definition. Despite the differences in definition, researchers confirmed the same cohort of patients, and they do not anticipate a notable impact on numbers of patients included in clinical treatment protocols or studies.
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Utilizing a Novel Methodology to Identify Emergency Department Patients with Diabetic Ketoacidosis

  • Description: Researchers reported on a new approach featuring automated and manual aspects, designed to retrospectively identify a subgroup of patients with diabetic ketoacidosis within an implantation trial.
  • Conclusion: Researchers found that very few patients were included who did not have an ICD10 code for diabetic ketoacidosis. The novel methodology for diabetic ketoacidosis cohort identification may be used to help develop real-time practice alerts in emergency department settings as well as future research studies.
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Hypoglycemic Events in a Subcutaneous Insulin Protocol for the Treatment of Diabetic Ketoacidosis

  • Objectives: This study was designed to compare the safety and efficacy of a novel subcutaneous insulin protocol using intravenous insulin treatment for mild to moderate diabetic ketoacidosis in the emergency department. Researchers would also compare hypoglycemic events in the subcutaneous insulin protocol versus the intravenous insulin infusion group. 
  • Conclusion: The subcutaneous insulin saw faster time to anion gap closure, less ICU admissions, and a decrease in hypoglycemic events compared to continuous intravenous insulin infusion. Researchers concluded that the implementation of a standardized subcutaneous insulin protocol using rapid-acting insulin aspart with or without long-acting insulin glargine is safe and effective as an alternative to intravenous insulin for mild to moderate diabetic ketoacidosis.
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Triage Point-of-Care Ketone Measurements: Association with Diabetic Ketoacidosis and Severity

  • Description: Researchers strove to uncover if triage point of care ketone measurements alone can accurately identify patients with diabetic ketoacidosis or stratify initial severity.
  • Conclusion: While the initial findings indicate a strong association between initial point of care ketone measurements, diabetic ketoacidosis, and severity, additional research is needed to optimize point-of-care-based algorithms for early detection of diabetic ketoacidosis.
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