Basal-Bolus Insulin Therapy in the Inpatient Management of Patients With Type 2 Diabetes

Objective: We sought to study the optimal management of hyperglycemia in non– intensive care unit patients with type 2 diabetes, as few studies so far have focused on this subject. Materials & Methods: We conducted a retrospective study to compare the efficacy and safety of a basal-bolus insulin regimen with that of sliding-scale regular insulin (SSI) in patients with type 2 diabetes. A total of 104 patients were included in this study. Results: Patients treated with basal insulin regimen had better glycemic control than those treated with SSI. The mean hospital length of stay was shorter in patients treated with basal-bolus as compared to the SSI-treated group. The mean glucose concentration during the last day of hospitalization was significantly higher in patients treated with SSI compared with those treated with the basal-bolus regimen At the same time, mean daily dose of insulin was significantly higher in the basal-bolus regimen compared with that in the SSI treatment group. Conclusion: Treatment with basal bolus insulin regimen resulted in significant improvement in glycemic control compared with that achieved with the use of SSI alone. Our study indicates that a basal-bolus insulin regimen should be preferred over SSI in the management of non– critically ill, hospitalized patients with type 2 diabetes.