Inpatient Diabetes on Corticosteroids
Summary
Despite a significant problem with out-of-control glucose levels in patients with diabetes receiving corticosteroids for a variety of illnesses, there are no published protocols addressing how to adequately treat corticosteroid-induced hyperglycemia. Investigators propose to test a protocol using scheduled dosing of NPH (Neutral protamine Hagedorn) insulin for inpatients with diabetes receiving corticosteroids. NPH insulin action is ideally timed to counteract corticosteroid-induced hyperglycemia, and the dose is added to the patient's usual insulin regimen and timed to correspond to the corticosteroid dosing regimen. Investigators will prospectively enroll eligible consented patients with diabetes who are receiving corticosteroids as part of their treatment in a large county hospital, will randomize them to intervention or control groups, and will monitor their glucose levels during their inpatient stay. The protocol will demonstrate improved control of glucose levels with minimal risk of hypoglycemia, and will provide a practical and readily implementable protocol using NPH insulin as therapy for corticosteroid-induced diabetes.
Timeline
- Start
- 2014-07
- Primary completion
- 2016-06
- Completion
- 2016-06
Outcome
Met primary endpoint
paper Mean blood glucose level was lower in the intervention (n = 29) than in the usual care (n = 31) group [226.12 vs. 268.57 mg/dL PMID 29961246 ↗
paper p < 0.0001 PMID 29961246 ↗
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | NPH | Protein / enzyme biologic | 0.1 iu/kg | — |
| Subject | NPH | Protein / enzyme biologic | 0.15 iu/kg | — |
| Subject | NPH | Protein / enzyme biologic | 0.2 iu/kg | — |
| Subject | NPH | Protein / enzyme biologic | 0.3 iu/kg | — |