Evaluation of Basal Insulin Dose Reductions in Hospitalized Patients With Diabetes While Unable to Eat

摘要

Background:The American Diabetes Association guidelines recommend a basal plus correction or basal insulin regimen for patients with type 2 diabetes mellitus (T2DM) receiving nothing by mouth (NPO; nil per os) in the non-intensive care unit setting. In the perioperative setting, 60% to 80% of long-acting insulin or half-dose morning insulin NPH is recommended.Objective:The goal of this study was to determine the impact of basal insulin dose reduction for hospitalized patients with insulin-dependent T2DM while NPO.Methods:This retrospective, single-center study evaluated patients admitted to the non-intensive care unit setting. Administration of >50% of home basal insulin was compared with administration of 180 mg/dL), and hospital length of stay (LOS).Results:Two hundred fifty-eight patient encounters were included, of which 85 and 173 patients received 50% of their home basal insulin dose, respectively. There were no significant differences in hypoglycemia (21.2% vs 21.4%;P= .97), severe hypoglycemia (1.2% vs 2.9%;P= .67), and hospital LOS (3 [IQR 2.13-6.74] days vs 4.66 [IQR 2.94-8.17] days;P= .74). Hyperglycemia occurred at a higher rate in patients receiving 50% of their home basal insulin.