The Study
The Role of Bicarbonate Therapy in Diabetic Ketoacidosis: A Systematic Review and Meta‐Analysis
This study looked at lots of past studies about giving bicarbonate to people with diabetic ketoacidosis. It found that bicarbonate didn't really help fix the acid problem or make people feel better faster. But it didn't prove that bicarbonate causes those problems—it just showed that people who got it sometimes stayed in the hospital longer or had higher sugar levels.
Analysis score
Maximum 85 for a systematic review with meta-analysis.
Where the score came from
Doctors sometimes give baking soda to people with severe diabetic coma to fix acid in their blood, but this study looked at many patients and found it doesn't really help.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 553 / 100
Quality score
Systematic reviews and meta-analyses of cohort studies. They sit above a single cohort study but below a single randomized trial, because the underlying evidence is still observational.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Raising blood sugar and extending hospital stays are bad outcomes — this means baking soda may hurt more than help in most DKA cases.
- 2Baking soda didn't fix blood acid (pH), didn't make patients recover faster, didn't help potassium levels, and didn't prevent low blood sugar.
- 3It did raise blood sugar by 37.7 mg/dL and made hospital stays 13.6 hours longer.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Endocrinology, Diabetes & Metabolism
Year
2026
Authors
A. Omayer, Anil Kc, A. Sharif, S. Hoque, Hasan A BaniHani, Lana Khaled, Waseem Sajjad, Moussa Nassar, Ahmad Holeihel
Related Content
Claims (6)
Diabetic ketoacidosis, alcoholic ketoacidosis, and severe dehydration cause metabolic acidosis by exceeding the body's natural ability to neutralize excess acid.
In patients with diabetic ketoacidosis, receiving bicarbonate therapy results in a 37.7 mg/dL higher blood glucose level compared to patients receiving standard care without bicarbonate.
In patients with diabetic ketoacidosis, receiving bicarbonate therapy is linked to a hospital stay that is about 13.6 hours longer than receiving standard care without bicarbonate.
In patients with diabetic ketoacidosis, adding bicarbonate to standard treatment does not change arterial pH, speed up recovery from acidosis, or alter serum potassium levels compared to standard treatment alone.
Bicarbonate therapy does not lower the risk of low blood sugar in patients with diabetic ketoacidosis.
In patients with diabetic ketoacidosis, giving bicarbonate therapy does not raise blood bicarbonate levels more than standard care alone, and it does not correct the acidosis.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.