OBJECTIVE -To compare two subcutaneous insulin strategies for glycemic management of hyperglycemia in non-critically ill hospitalized patients with diabetes during enteral nutrition therapy (ENT).RESEARCH DESIGN AND METHODS -Fifty inpatients were prospectively randomized to receive sliding-scale regular insulin (SSRI) alone (n ϭ 25) or in combination with insulin glargine (n ϭ 25). NPH insulin was added for persistent hyperglycemia in the SSRI group (glucose Ͼ10 mmol/l).RESULTS -Glycemic control was similar in the SSRI and glargine groups (mean Ϯ SD study glucose 8.9 Ϯ 1.6 vs. 9.2 Ϯ 1.6 mmol/l, respectively; P ϭ 0.71). NPH insulin was added in 48% of the SSRI group subjects. There were no group differences in frequency of hypoglycemia (1.3 Ϯ 4.1 vs. 1.1 Ϯ 1.8%; P ϭ 0.35), total adverse events, or length of stay.CONCLUSIONS -Both insulin strategies (SSRI with the addition of NPH for persistent hyperglycemia and glargine) demonstrated similar efficacy and safety in non-critically ill hospitalized patients with type 2 diabetes during ENT.

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A diabetes order set with prescribing guidelines can safely and effectively be implemented in hospitals. The success of this intervention is attributed to the contribution of nurses, pharmacists and prescribers in the design and implementation of the order set, the provider education accompanying order set implementation and the feedback following implementation.

Since the release of the Diabetes Control and Complications Trial (DCCT), there has been a trend to intensify therapy in children with type1 diabetes even though the trial did not include children of less than 13 years. There has also been a plethora of new diabetes information and technological advances recently. Providing diabetes care, particularly intensive therapy, for the child with diabetes creates a special challenge when insulin and blood glucose monitoring are now needed in school. Regulations in the United States federal laws mandate services for children with disabilities in the school. School personnel must be knowledgeable on new advances and prepared to actively participate in diabetes care. In response to the rapid changes and new information, the Children's Hospital of Pittsburgh Diabetes Center assessed the knowledge level and needs of school personnel and implemented a comprehensive education program. The program was entitled the`5 Cs of diabetes', which highlighted new information in the areas of cause, classi®cation, complications (acute and chronic), care and cure. The program was presented in six school districts (156 school personnel). A ten-item multiple pre-and post-test was administered. Participants showed a statistically signi®cant improvement in knowledge scores. This study demonstrated the need to provide new diabetes information to school personnel and that the`5 Cs' program design was extremely ef®cacious in educating school personnel.

Among patients with diabetes and stable ischemic heart disease, higher SYNTAX scores predict higher rates of major cardiovascular events and were associated with more favorable outcomes of revascularization compared with medical therapy among patients suitable for CABG. (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes; NCT00006305).