Management of diabetes mellitus in an acute care setting

Abstract EN

The aim of this study was to evaluate the efficacy of the addition of twice daily doses of intermediate acting insulin to the conventional sliding scale in patients with Type 2 diabetes admitted for medical illness other than diabetes.

Fifty patients were started on conventional sliding scale and the other fifty were treated by the same sliding scale with the addition of twice daily intermediate acting insulin.

Twenty-five (50%) patients assigned to conventional sliding scale showed poor blood sugar results, >250 mg/dl (mean 276 mg/dl); whereas, only two patients on the conventional sliding scale with addition of intermediate acting insulin showed poor blood sugar control.

Blood sugar results > 180 < 250 were found in 15 (30%) patients on sliding scale patients whereas only in 8 (16%) patients on NPH insulin.

Good blood sugar results, <180 mg/dl, were obtained in 40 (80%) patients with addition of NPH but only 10 (20%) patients on sliding scale alone showed good control.

We conclude that the addition of intermediate acting insulin to the conventional sliding scale revealed significant improvement in blood glucose control (P-value > 0.2) compared with conventional sliding scale alone in patients with diabetes mellitus during acute medical illness.