Effects of preprandial versus postprandial nutritional insulin administration in the inpatient setting
Authors' conclusion
Implementing a hospital-wide shift to postprandial nutritional insulin administration significantly reduced hypoglycemia rates without increasing severe hyperglycemia. This suggests a promising strategy for improving patient safety, but further prospective randomized controlled trials are warranted to confirm these findings.
Study context
- Population
- Adult inpatients receiving nutritional insulin at a community hospitalpatient-days analysed
- Exposure
- Postprandial vs preprandial nutritional insulin administration
- Outcome
- Hypoglycemia (glucose ≤ 70 mg/dL) and severe hypoglycemia (≤ 40 mg/dL)
Methodological detailssingle community hospital, pre-post (three time periods), multivariate adjustment
- Single community hospital
- Pre-post (three time periods)
- Multivariate adjustment
Main finding
As reported in the abstract
- Risk of any hypoglycemia and severe hypoglycemia significantly decreased over time
- Pre-intervention vs Distant post-intervention: P = 0.001
- Pre-intervention vs Distant post-intervention: P = 0.009
- Multivariate adjustment
Observational data: associations, not effects.
Further findings
Daily mean glucose
- Daily mean glucose increased over time
- P = 0.003
Severe hyperglycaemia (≥ 300 mg/dL)
- No significant differences among rates of severe hyperglycaemia
- P = 0.10
Length of stay (LOS)
- No significant differences in LOS
- P = 0.74
Original publication
Effects of preprandial versus postprandial nutritional insulin administration in the inpatient setting. Diabetes Res Clin Pract. Published 15 July 2024. doi:10.
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