Association Between Daily Insulin Dose Adjustments and Glycemic Control in Noncritically Ill Hospitalized Hyperglycemic Patients: A Retrospective Cohort Study
Authors' conclusion
More intensive insulin adjustments may be required for inpatient hyperglycemia compared to the typical 10% to 20% recommendation. Prospective studies are needed to validate and build upon these retrospective findings.
Study context
- Population
- Noncritically ill hospitalised hyperglycaemic patients receiving ≥10 units of basal insulin on any day, 2 urban academic medical centres and 3 suburban community hospitals, 2015–2019; median age 64, 53.4% male, 52.1% White; T2D coded in 54.7%, 36.3% without diabetes code
- Participants
- 25,186 hospital admissions
- Exposure
- Daily insulin dose increase categories on hyperglycaemic days
- Outcome
- Average BG ≤160 mg/dL without hypoglycaemia on the following day
- Follow-up
- Following day
Methodological detailsmulticentre, 240 556 hospital days and 63 033 hyperglycaemic index days analysed; median blood glucose (BG) 222.7 mg/dL
- Multicentre
- 240 556 hospital days and 63 033 hyperglycaemic index days analysed; median BG 222.7 mg/dL
Main finding
As reported in the abstract
- A 44% to 100% increase in total daily dose (TDD) was significantly more likely to achieve the primary outcome vs a 10% to 22% increase
- Insulin dose adjustments showed a strong correlation with glycaemic control
- 4 dose-increase categories; only these two named in the abstract
Observational data: associations, not effects.
Further findings
Consistency across BG ranges and dosing categories
- Trend remained consistent across varied BG ranges and dosing categories
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Association Between Daily Insulin Dose Adjustments and Glycemic Control in Noncritically Ill Hospitalized Hyperglycemic Patients: A Retrospective Cohort Study. Endocr Pract. Published 28 January 2025. doi:10.
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