Under‐ and overdosing insulin in the hospital: A retrospective cohort study of dose deviation and patient outcomes
Main finding · 30-day mortalityResult — go to the resultAdjusted hazard ratio 1.273 95% CI 1.024–1.583Authors' conclusion
Deviation from guideline-based insulin dosing is common in hospitalized adults with type 2 diabetes. Undertreatment was associated with increased 30-day mortality and prolonged hospitalization. Monitoring insulin dose deviation may help identify patients at risk for adverse outcomes.
Study context
- Population
- Non-critically ill hospitalized adults with T2D receiving ≥ 24 h of subcutaneous insulin, tertiary academic medical centre (2010–2025)
- Participants
- 3,430 participants
- Exposure
- Insulin undertreatment or overtreatment vs guideline-concordant dosing
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailssingle tertiary academic medical centre
- Single tertiary academic medical centre
Main finding
As reported in the abstract
Adjusted hazard ratio
1.273
95% CI 1.024–1.583
P = 0.03
Undertreatedvs Guideline-concordant
aHR 1.273 (95% CI 1.024–1.583); P = 0.03
Observational data: associations, not effects.
Further findings
Dosing distribution
Hyperglycaemia and LOS
- Undertreated patients had more hyperglycaemia and longer hospital stays
- P < 0.001
Safety
Hypoglycaemia · 30 days
- Hypoglycaemia rates were similar between groups
Original publication
Under‐ and overdosing insulin in the hospital: A retrospective cohort study of dose deviation and patient outcomes. Diabet Med. Published 25 June 2026. doi:10.
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