Glycemic Control in Medical Inpatients with Type 2 Diabetes Mellitus Receiving Sliding Scale Insulin Regimens versus Routine Diabetes Medications: A Multicenter Randomized Controlled Trial
| Autor: | Lori M. Dickerson, Xiaobu Ye, William J. Hueston, Jonathan L. Sack |
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| Rok vydání: | 2003 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty endocrine system diseases medicine.medical_treatment Comorbidity Hypoglycemia Drug Administration Schedule law.invention Randomized controlled trial law Internal medicine Diabetes mellitus Humans Hypoglycemic Agents Insulin Medicine Prospective Studies Intensive care medicine Original Research Aged Glycemic Inpatients business.industry nutritional and metabolic diseases Type 2 Diabetes Mellitus Length of Stay Middle Aged medicine.disease Regimen Diabetes Mellitus Type 2 Hyperglycemia Female Family Practice business |
| Zdroj: | The Annals of Family Medicine. 1:29-35 |
| ISSN: | 1544-1717 1544-1709 |
| DOI: | 10.1370/afm.2 |
| Popis: | PURPOSE Hospitalized patients with type 2 diabetes mellitus traditionally receive insulin on a sliding-scale regimen, but the benefits of this approach are unclear. The purpose of this study was to compare the effects of the sliding scale insulin regimen with those of routine diabetes medications on hyperglycemia, hypoglycemia and length of hospitalization in diabetic patients hospitalized for other conditions. METHODS This was a multicenter, randomized controlled trial conducted in family medicine inpatient services. One hundred fifty-three patients with type 2 diabetes mellitus hospitalized for other conditions were randomized to receive routine diabetes medications (control) or the combination of a standard sliding-scale insulin regimen and routine diabetes medications (intervention). The outcome measures included frequency of hyperglycemia and hypoglycemia (glycemic events), and length of hospitalization. RESULTS No differences were identified between treatment groups in the frequency of glycemic events. In the intervention group, 33.3% of patients developed hyperglycemia compared to 34.6% in the control group (P = .87). Six patients developed hypoglycemia in the intervention group, compared with 7 in the control group (P = .83). There was no difference in length of hospitalization (P = .86). Regardless of treatment assignment, patients receiving intermediate-acting insulin (OR, 2.8; 95% CI, 1.2–6.5), those with blood glucose values greater than 250 mg/dL at baseline (OR, 6.3; 95% CI, 2.3 – 17.2) and those receiving corticosteroids (OR, 9.1; 95% CI, 3.1 – 27.0) were more likely to have glycemic events. CONCLUSIONS The use of the sliding scale insulin regimen in combination with routine diabetes medications does not affect the rate of hyperglycemia, hypoglycemia or length of hospitalization in patients with type 2 diabetes mellitus hospitalized for other conditions. |
| Databáze: | OpenAIRE |
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