Insulin Therapy and Glycemic Control in Hospitalized Patients With Diabetes During Enteral Nutrition Therapy A randomized controlled clinical trial

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 (SSR1) alone (n = 25) or in combination with insulin glargine (n = 25) NPH insulin was added for persistent hyperglycemia in the SSR1 group (glucose > 10 mmol/l). RESULTS - Glycemic control was similar in the SSR1 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 SSR1 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 (SSR1 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.