Randomized clinical trial of the efficacy and safety of insulin glargine vs. NPH insulin as basal insulin for the treatment of glucocorticoid induced hyperglycemia using continuous glucose monitoring in hospitalized patients with type 2 diabetes and respiratory disease

Management of hospitalized type 2 diabetes mellitus patients

“…Although without statistically significat difference, in both articles was found more rate of hypoglycemia in NPH group. [46,47] Surgery Hyperglycemia is associated with increased risk for adverse outcomes in patients undergoing surgery: more length of stay, postoperative complications, infections, and more mortality. [48,49] The recommendations and the treatment depend on the type of diabetes, surgical procedure, when patient is going to resume feeding, previous diabetic treatment, glucose control, and metabolic state of patients.…”

Evaluación de la eficacia y la seguridad de un protocolo de manejo de pacientes con diabetes descompensada por glucocorticoides durante la hospitalización

“…En nuestro trabajo obtuvimos con el PC una GM de 192 mg/dl, frente a una GM de 205 mg/dl en el grupo tratado con el PG. Ruiz de Adana et al 16 Evaluación de un protocolo de manejo de diabetes descompensada por corticoides 7 de 205 mg/dl en el grupo asignado a tratamiento basal-bolo, con una dosis de insulina por kg de peso de 0,64 unidades. Este dato refuerza el mensaje de que es fundamental la dosis de insulina alcanzada, ya que en nuestro PC llegó a ser de 0,94 unidades por kilogramo de peso y día.…”

“…Radhakutty et al, en su análisis de control glucémico los días 1 y 3 del ingreso aplicando una pauta basal-bolo versus insulina NPH, no observaron diferencias significativas ni en el control glucémico ni en la incidencia de hipoglucemias 19 . Otros estudios también han encontrado una eficacia similar entre NPH y pauta basal-bolo 16,18 . En nuestro estudio se usó una pauta bolo-basal diferente de la recomendada por Perez et al 1 para minimizar el riesgo de hipoglucemias, desplazando parte de la insulina de vespertina a la merienda.…”

Treatment of prednisolone‐induced hyperglycaemia in hospitalized patients: Insights from a randomized, controlled study

“…There have been few prospective studies specifically investigating treatment of hyperglycaemia in patients receiving glucocorticoids. In patients with type 2 diabetes and respiratory disease who are being treated with methylprednisolone or deflazacort, there were no significant differences in glucose control between patients randomized to a glargine‐ or isophane‐based basal bolus regimen . Another study reported that additional isophane insulin when glucocorticoids were administered as well as the standard hospital insulin regimen resulted in a lower mean glucose concentration on the third day of insulin therapy .…”