Research Article CODEN: IJPNL6 TAWAM HOSPITAL IN-PATIENT GLYCEMIC CONTROL: IT’S TIME TO STOP SLIDING

The objective of the present work is to develop best practice for enabling targeted glycemic control in the medical and surgical setting considering the multiple factors contributing to hypo/hyperglycemia. A randomized trial comparing the safety and efficacy of a basal-bolus (BB) insulin regimen with glargine insulin once daily and aspart insulin before meals (n = 60) to sliding scale regular insulin (SSI) with regular insulin four times daily (n = 90) in patients with type 2 diabetes mellitus admitted to the medical and general surgery ward. Outcomes included differences in daily blood glucose, hospital length of stay and hypoglycemia/hyperglycemia occurrences. There was a 27 % and 15 % reduction in the average length of stay in the medical and surgical wards respectively post implementation of new regimen. Secondly 68 % and 902 % reductions in the hypoglycemic episodes per 100 patient days in the medical and surgical ward respectively post implementation of the new regimen. Basal-bolus treatment with glargine insulin once daily plus aspart insulin before meals improved glycemic control and reduced hospital complications compared with SSI in general surgery patients. Our study indicates that a basal-bolus insulin regimen is preferred over SSI in the hospital management of medical and surgery patients with type 2 diabetes