Insulin therapy and glycemic control in hospitalized patients with diabetes during enteral nutrition therapy: a randomized controlled clinical trial
Mary T Korytkowski, Rose J Salata, Glory L Koerbel, Faith Selzer, Esra Karslioglu, Almoatazbellah M Idriss, Kenneth K W Lee, A James Moser, Frederico G S Toledo, Mary T Korytkowski, Rose J Salata, Glory L Koerbel, Faith Selzer, Esra Karslioglu, Almoatazbellah M Idriss, Kenneth K W Lee, A James Moser, Frederico G S Toledo
Abstract
Objective: To compare two subcutaneous insulin strategies for glycemic management of hyperglycemia in non-critically ill hospitalized patients with diabetes during enteral nutrition therapy (ENT).
Research design and methods: Fifty inpatients were prospectively randomized to receive sliding-scale regular insulin (SSRI) alone (n = 25) or in combination with insulin glargine (n = 25). NPH insulin was added for persistent hyperglycemia in the SSRI group (glucose >10 mmol/l).
Results: Glycemic control was similar in the SSRI and glargine groups (mean +/- SD study glucose 8.9 +/- 1.6 vs. 9.2 +/- 1.6 mmol/l, respectively; P = 0.71). NPH insulin was added in 48% of the SSRI group subjects. There were no group differences in frequency of hypoglycemia (1.3 +/- 4.1 vs. 1.1 +/- 1.8%; P = 0.35), total adverse events, or length of stay.
Conclusions: Both insulin strategies (SSRI with the addition of NPH for persistent hyperglycemia and glargine) demonstrated similar efficacy and safety in non-critically ill hospitalized patients with type 2 diabetes during ENT.
Trial registration: ClinicalTrials.gov NCT00177398.
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Source: PubMed