Evaluation of glycemic control using NPH insulin sliding scale versus insulin aspart sliding scale in continuously tube-fed patients.
BACKGROUND
Hyperglycemia is often a problem in patients who receive continuous enteral nutrition. The purpose of this study was to determine if the use of sliding-scale neutral protamine Hagedorn (NPH) insulin was more effective than sliding-scale insulin aspart in controlling blood glucose in continuously tube-fed patients.


METHODS
A retrospective, records-based review comparing sliding-scale NPH insulin given every 4 or 6 hours with sliding-scale insulin aspart was performed in patients admitted to 2 community hospitals between April 1, 2006, and September 30, 2007.


RESULTS
Mean blood glucose was found to be lower in patients receiving NPH every 4 hours and NPH every 6 hours than in patients receiving insulin aspart (P < .001). No statistically significant differences in mean blood glucose values (P = .41) were observed between patients receiving the NPH regimen given every 4 or 6 hours. More patients in the NPH groups had blood glucose values in the target and acceptable ranges than those in the insulin aspart group (P < .001), but no statistical significance was observed between the groups receiving NPH every 4 hours and NPH every 6 hours (P = .41).


CONCLUSIONS
In this study, sliding-scale NPH insulin was demonstrated to be a safe and effective management strategy for blood glucose control in continuously tube-fed patients; NPH insulin resulted in better blood glucose control compared with insulin aspart.
Cook
Amber
A
St. Vincent Indianapolis Hospital, Indianapolis, Indiana, USA. amcook4@stvincent.org
Burkitt
Dora
D
McDonald
Lynn
L
Sublett
Laurie
L
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D004334:Drug Administration Schedule; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D061267:Insulin Aspart; D007336:Insulin, Isophane / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D007336:Insulin, Isophane; D061267:Insulin Aspart