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 basalbolus 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.