PMID- 32742013
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210802
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 55
IP  - 4
DP  - 2020 Aug
TI  - Evaluation of Basal Insulin Dose Reductions in Hospitalized Patients With 
      Diabetes While Unable to Eat.
PG  - 246-252
LID - 10.1177/0018578719841029 [doi]
AB  - Background: The American Diabetes Association guidelines recommend a basal plus 
      correction or basal insulin regimen for patients with type 2 diabetes mellitus 
      (T2DM) receiving nothing by mouth (NPO; nil per os) in the non-intensive care 
      unit setting. In the perioperative setting, 60% to 80% of long-acting insulin or 
      half-dose morning insulin NPH is recommended. Objective: The goal of this study 
      was to determine the impact of basal insulin dose reduction for hospitalized 
      patients with insulin-dependent T2DM while NPO. Methods: This retrospective, 
      single-center study evaluated patients admitted to the non-intensive care unit 
      setting. Administration of >50% of home basal insulin was compared with 
      administration of </=50% of home basal insulin. The primary outcome was the 
      difference in hypoglycemic events (blood glucose [BG] < 70 mg/dL). Secondary 
      outcomes included comparing severe hypoglycemic events (BG < 40 mg/dL), 
      hyperglycemic events (BG > 180 mg/dL), and hospital length of stay (LOS). 
      Results: Two hundred fifty-eight patient encounters were included, of which 85 
      and 173 patients received </=50% and >50% of their home basal insulin dose, 
      respectively. There were no significant differences in hypoglycemia (21.2% vs 
      21.4%; P = .97), severe hypoglycemia (1.2% vs 2.9%; P = .67), and hospital LOS (3 
      [IQR 2.13-6.74] days vs 4.66 [IQR 2.94-8.17] days; P = .74). Hyperglycemia 
      occurred at a higher rate in patients receiving </=50% of their home basal insulin 
      dose (97.6% vs 89%; P = .02). Conclusions: No differences were observed in 
      hypoglycemic events between those patients receiving </=50% and >50% of their home 
      basal insulin.
CI  - (c) The Author(s) 2019.
FAU - Petite, Sarah E
AU  - Petite SE
AD  - The University of Toledo, OH, USA.
FAU - Huenecke, Joseph
AU  - Huenecke J
AD  - Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Tuttle, Natalie
AU  - Tuttle N
AD  - The University of Toledo Medical Center, OH, USA.
LA  - eng
PT  - Journal Article
DEP - 20190408
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC7370343
OTO - NOTNLM
OT  - disease management
OT  - endocrine
OT  - medication safety
OT  - metabolic
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2020/08/04 06:00
MHDA- 2020/08/04 06:01
PMCR- 2021/08/01
CRDT- 2020/08/04 06:00
PHST- 2020/08/04 06:00 [entrez]
PHST- 2020/08/04 06:00 [pubmed]
PHST- 2020/08/04 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 10.1177_0018578719841029 [pii]
AID - 10.1177/0018578719841029 [doi]
PST - ppublish
SO  - Hosp Pharm. 2020 Aug;55(4):246-252. doi: 10.1177/0018578719841029. Epub 2019 Apr 
      8.