Comparison of 70/30 biphasic insulin with glargine/lispro regimen in non-critically ill diabetic patients on continuous enteral nutrition therapy.
Despite significant advances in inpatient diabetes management, it is still a challenge to choose the safest and most efficacious subcutaneous insulin regimen for diabetic patients on continuous enteral nutrition (EN) therapy. The authors conducted a retrospective analysis of glycemic control in 22 non-critically ill diabetic patients, receiving at least 3 days of continuous EN. Patients received different insulin regimens while on continuous EN, including a basal/bolus glargine/lispro regimen (group 1, n = 8), 70/30 biphasic insulin twice daily (group 2, n = 8), and 70/30 biphasic insulin 3 times a day (group 3, n = 6). The glucose data from 72 hours from the initiation of EN were analyzed (12 point-of-contact glucose measurements per patient). Overall, the degree of control was comparable in all groups, with target range maintained more consistently in group 3 (70/30 insulin administered 3 times daily). In this group, 69% of values were in the target range (140-180 mg/dL) as compared with 24% in glargine/lispro group and 22% in the 70/30 insulin bid group. Eight hypoglycemic episodes occurred among the 3 groups: 5 episodes in group 1 (5.4%), 2 episodes in group 2 (2.1%), and 1 episode in group 3 (1.4%) (P = .05, groups 2 and 3 vs group 1). Administration of 70/30 biphasic insulin 3 times daily is a safe therapeutic regimen in diabetic patients on continuous EN as it maintains glycemia in the target range and might produce fewer episodes of hypoglycemia.
Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Denver, 12801 E 17th Ave, Aurora, CO 80045, USA.
Elisa
E
Hsia
Stacey A
SA
Seggelke
Joanna
J
Gibbs
Neda
N
Rasouli
Boris
B
Draznin
D000328:Adult; D000368:Aged; D061265:Biphasic Insulins / Q000008:administration & dosage* / Q000032:analysis; D001786:Blood Glucose; D003920:Diabetes Mellitus / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004750:Enteral Nutrition / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000628:therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000032:analysis; D000069036:Insulin Glargine; D061268:Insulin Lispro / Q000008:administration & dosage* / Q000032:analysis; D049528:Insulin, Long-Acting / Q000008:administration & dosage* / Q000032:analysis; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
D061265:Biphasic Insulins; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D061268:Insulin Lispro; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine