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

Nutr Clin Pract. 2011 Dec;26(6):714-7. doi: 10.1177/0884533611420727.

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.

Publication types

  • Comparative Study

MeSH terms

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

Substances

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