70/30 Insulin Algorithm Versus Sliding Scale Insulin

Schoeffler, J Megan; Rice, Dennis A.K.; Gresham, Douglas G

doi:10.1345/aph.1e661

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…Furthermore, contrary to what has been implied (7), this study refutes the statement that the sliding-scale method is associated with frequent hypoglycemia. Additionally, this study corroborates similar findings in a smaller prospective but nonrandomized study comparing insulin 70/30 (the ratio of 70% NPH to 30% regular insulin) with SSI, in which both groups received a comparable dose of insulin (13). The superiority of the basalbolus regimen in this study may be attributable to suboptimal insulin dosing in the SSI arm rather than to inferiority of the sliding technique per se.…”

supporting

confidence: 88%

Sliding-Scale Insulin

Kitabchi

Nyenwe

2007

Diabetes Care

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supporting

confidence: 88%

Sliding-Scale Insulin

Kitabchi

Nyenwe

2007

Diabetes Care

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“…An even simpler way to introduce a basal-bolus in non-ICU inpatients with Type 2 diabetes was demonstrated in a pilot study of protocol-based pharmacist titration of 70/30 insulin twice daily compared with SSI regimens alone. The 70/30 insulin regimen was associated with improved glycemic control without increased hypoglycemia [85].…”

Section: Strategies To Improve Inpatient Diabetes Managementmentioning

confidence: 93%

Inpatient diabetes management in general medical and surgical settings: evidence and update

Wexler¹

2007

Expert Review of Pharmacoeconomics & Outcomes Research

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A quarter of patients who are hospitalized for any reason have diabetes as a comorbid condition. Despite this, management of diabetes among inpatients has historically been a low clinical priority. Since the publication of several landmark trials demonstrating the benefits of intensive glycemic control in the surgical intensive care unit, inpatient glycemic control on general hospital wards has received increased attention. Physicians and healthcare organizations in the USA have recently advocated more aggressive treatment of inpatient hyperglycemia despite the lack of data to guide evidence-based management in general (non-intensive care unit) settings. These calls to action have prompted a series of studies that demonstrate effective systems-based strategies for measuring and improving inpatient glycemic control, even though it is not yet clear how aggressively this goal should be pursued. While the data on improved long-term outcomes related to improved glycemic control in general inpatient settings are sparse, at the very least, inpatient diabetes management is likely to be beneficial if it prevents extremes of hyper- and hypoglycemia, decreases medication error, and facilitates improved outpatient medication regimens and self-management skills, which, in turn, may lead to improved glycemic control after discharge.

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“…In this section, we will not repeat generalized arguments against sliding-scale monotherapy [58][59][60][61] or strategies for transitioning from intravenous to subcutaneous insulin, which have been treated elsewhere [40,54,[62][63][64][65][66][67][68][69].…”

Section: Glycemic Target Appropriate For Condition Hypoglycemia and mentioning

confidence: 99%

Practical aspects of intensive insulinization in the intensive care unit

Boulkina

Braithwaite

2007

Current Opinion in Clinical Nutrition and Metabolic Care

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Attainment and preservation of glycemic control among critically ill patients are best attempted with intravenous insulin infusion. Advances in the design of decision support and insulin delivery systems, and progress in the technology of continuous blood glucose monitoring, are likely to reduce the risk of hypoglycemia, without compromise of target range control, such that the patient outcomes enjoyed by experienced centers in the future will prove generalizable to others through the extension of new technologies.

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70/30 Insulin Algorithm Versus Sliding Scale Insulin

Abstract: Glycemic control with the 70/30 insulin algorithm was superior to traditional SSI dosing.

Cited by 21 publications

References 19 publications

Sliding-Scale Insulin

Sliding-Scale Insulin

Inpatient diabetes management in general medical and surgical settings: evidence and update

Practical aspects of intensive insulinization in the intensive care unit

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