Comparison of 70/30 biphasic insulin with glargine/lispro regimen in non-critically ill diabetic patients on continuous enteral nutrition therapy.

Abstract

Despite significant advances in inpatient diabetes management, it is still a challenge to choose the safest and most efficacious subcutaneous insulin regimen for diabetic patients on continuous enteral nutrition (EN) therapy. The authors conducted a retrospective analysis of glycemic control in 22 non-critically ill diabetic patients, receiving at least 3 days of continuous EN. Patients received different insulin regimens while on continuous EN, including a basal/bolus glargine/lispro regimen (group 1, n = 8), 70/30 biphasic insulin twice daily (group 2, n = 8), and 70/30 biphasic insulin 3 times a day (group 3, n = 6). The glucose data from 72 hours from the initiation of EN were analyzed (12 point-of-contact glucose measurements per patient). Overall, the degree of control was comparable in all groups, with target range maintained more consistently in group 3 (70/30 insulin administered 3 times daily). In this group, 69% of values were in the target range (140-180 mg/dL) as compared with 24% in glargine/lispro group and 22% in the 70/30 insulin bid group. Eight hypoglycemic episodes occurred among the 3 groups: 5 episodes in group 1 (5.4%), 2 episodes in group 2 (2.1%), and 1 episode in group 3 (1.4%) (P = .05, groups 2 and 3 vs group 1). Administration of 70/30 biphasic insulin 3 times daily is a safe therapeutic regimen in diabetic patients on continuous EN as it maintains glycemia in the target range and might produce fewer episodes of hypoglycemia.

• Authors: Elisa Hsia, Stacey A Seggelke, Joanna Gibbs, Neda Rasouli, Boris Draznin
• Journal: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition (Nutr Clin Pract) Vol. 26 Issue 6 Pg. 714-7 (Dec 2011) ISSN: 1941-2452 [Electronic] United States
• PMID: 22205560 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biphasic Insulins
• Blood Glucose
• Hypoglycemic Agents
• Insulin Lispro
• Insulin, Long-Acting
• Insulin Glargine

Topics

• Adult
• Aged
• Biphasic Insulins (administration & dosage, analysis)
• Blood Glucose
• Diabetes Mellitus (therapy)
• Dose-Response Relationship, Drug
• Enteral Nutrition (methods)
• Hospitalization
• Humans
• Hypoglycemia (therapy)
• Hypoglycemic Agents (administration & dosage, analysis)
• Insulin Glargine
• Insulin Lispro (administration & dosage, analysis)
• Insulin, Long-Acting (administration & dosage, analysis)
• Middle Aged
• Retrospective Studies
• Young Adult