Sliding-Scale Insulin

Kitabchi, Abbas E.; Nyenwe, Ebenezer

doi:10.2337/dc07-1141

Cited by 14 publications

(3 citation statements)

References 18 publications

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“…There are several barriers to implementing BBI as “routine therapy” in hospitalised patients. These include an increased nursing workload, scepticism regarding the benefits of good glycaemic control, fear of hypoglycaemia, lack of specialist input, and an inadequate knowledge of diabetes on the part of the junior medical and nursing staff responsible for applying the protocol 22 . However, our study demonstrates that introducing BBI with limited education of junior medical and nursing staff reduces hyperglycaemia in hospitalised patients.…”

Section: Discussionmentioning

confidence: 69%

Basal–bolus insulin versus sliding‐scale insulin for inpatient glycaemic control: a clinical practice comparison

Roberts

Aguilar-Loza

Esterman

et al. 2012

Medical Journal of Australia

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Section: Discussionmentioning

confidence: 69%

Basal–bolus insulin versus sliding‐scale insulin for inpatient glycaemic control: a clinical practice comparison

Roberts

Aguilar-Loza

Esterman

et al. 2012

Medical Journal of Australia

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“…14 Sliding scale insulin (SSI), utilizing short-acting insulin to reactively manage hyperglycemia, is a widely established practice but may result in greater fluctuation in BG levels. [15][16][17] Alternatively, basal plus insulin (BPI) includes long-acting insulin that allows for more proactive and predictable glucose control. Compared with SSI regimens in hospitalized patients with diabetes, BPI regimens achieve lower mean BG levels.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Basal Plus Versus Sliding Scale Insulin Therapy on Glucose Variability in Critically Ill Patients Without Preexisting Diabetes

Webster,

Belfer,

Schmidt

2023

Ann Pharmacother

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Background: There is limited evidence evaluating the impact of insulin treatment strategies on glucose variability in critically ill patients without preexisting diabetes. Objective: Compare basal plus insulin (BPI) and sliding scale insulin (SSI) impact on glycemic control outcomes in critically ill patients without preexisting diabetes experiencing hyperglycemia. Methods: This multicenter, retrospective review analyzed critically ill patients with hyperglycemia who received either BPI or SSI. Patients with a hemoglobin A1C >6.5% during the admission of interest or in the previous 3 months, or a diagnosis of diabetes at the time of discharge were excluded. The primary outcome was glucose variability during the intensive care unit (ICU) admission. Secondary outcomes included hypoglycemia frequency, frequency of goal glucose levels, mortality, and length of stay. Results: The analysis included 228 patients (39 in BPI, 189 in SSI). Average glucose variability was higher in the BPI group compared with the SSI group (85.8 mg/dL ± 33.1 vs 70.2 mg/dL ± 30.7; P = 0.009), which remained when controlling for baseline confounding (−12.1 [5.6], 95% CI −23.2 to −0.99; P = 0.033). Hypoglycemia incidence was similar between groups. BPI patients had a lower incidence of glucose values within goal range than SSI patients ( P = 0.046). There was no difference in length of stay or hospital mortality. Conclusions and Relevance: The use of SSI compared with a BPI regimen may result in reduced glycemic variability in critically ill patients without preexisting diabetes. Future prospective studies, with a larger sample size, are warranted to confirm our exploratory findings and characterize clinically significant benefits.

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“…18 Sliding scale insulin attempts to correct hyperglycemia on a reactive basis rather than using a proactive strategy to achieve improved overall control. 19,20 As an alternative, basal insulin provides uniform action and can provide more predictable glucose control compared to repeated SSI doses. However, the effect of basal insulin typically lasts about 24 hours, and unlike SSI, it cannot be adjusted to reflect changes in the patient’s clinical condition.…”

Section: Introductionmentioning

confidence: 99%

Association Between the Use of Long-Acting Insulin and Hypoglycemia in Nondiabetic Patients in the Surgical Intensive Care Unit

Masse

Giuliano

Brown

et al. 2016

J Intensive Care Med

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Sliding-Scale Insulin

Cited by 14 publications

References 18 publications

Basal–bolus insulin versus sliding‐scale insulin for inpatient glycaemic control: a clinical practice comparison

Basal–bolus insulin versus sliding‐scale insulin for inpatient glycaemic control: a clinical practice comparison

Evaluation of Basal Plus Versus Sliding Scale Insulin Therapy on Glucose Variability in Critically Ill Patients Without Preexisting Diabetes

Association Between the Use of Long-Acting Insulin and Hypoglycemia in Nondiabetic Patients in the Surgical Intensive Care Unit

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