Basal Bolus vs. Sliding Scale for Treatment of Diabetic Patients in Medical Wards

HaEmek Medical Center, Israel36 enrolled

Overview

A comparison of two treatment approaches for hyperglycemia in diabetic patients hospitalized in the medical department. The first approach is called basal-bolus in which 4 insulin shots are given daily ( 3 short acting before meals and one long acting before bed time). The second approach is called sliding scale in which short acting insulin alone is given before meals and before bed time according to the patient's glucose values. The aim is to keep fasting glucose between 140-180 mg/dl.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Diabetes Mellitus Type 2

Interventions

Insulin, regular - act rapidDRUG

4 shots of regular insulin: 3 before meals and one at bedtime.

Insulin glulisine, Insulin glargineDRUG

1 shot glargine at bedtime 3 shots glulisine before meals

Eligibility

Sex: ALLMin age: 18 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients admitted to internal medicine ward with blood glucose (BG) between 140-400 mg/dl. * Known history (\>6months) of diabetes. * Aged 18-80 years old. * Previous therapy including either diet alone or any combination of oral hypoglycemia agents, glucagon-like peptide 1 (GLP-1) analogs and long acting insulin analogs or Neutral Protamine Hagedorn (NPH). Exclusion Criteria: * Pregnancy * Patients with ketoacidosis * Patients with unknown history of diabetes * Patients with type 1 diabetes mellitus * Patients with clinically relevant hepatic disease or renal impairment ( serum creatinine≥2.5 mg/dl) * Use of corticosteroid therapy * Patient with any mental disorder preventing him to cooperate and give informed consent. * Patients on multiple daily doses of insulin regimen.

Data from ClinicalTrials.gov

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