Retrospective Analysis of Once-Daily Versus Twice-Daily Insulin Glargine Dosing in Noncritically Ill Individuals

Q3 Medicine
Deasiah Hogue, Jennifer Clements, Adrienne Wright
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Abstract

Insulin is the treatment of choice for diabetes care in the hospital. There is some debate regarding the efficacy and safety of once-daily versus twice-daily insulin glargine in the hospital, particularly in the critically ill population. The purpose of this pilot study was to evaluate the efficacy and safety of insulin glargine administered as a once-daily versus twice-daily regimen in the noncritically ill population. A retrospective chart review was conducted from 1 June 2020 to 31 May 2021. Inclusion criteria were age ≥18 years and on a regimen of either once-daily or twice-daily insulin glargine for ≥72 hours during the specified time frame. The primary end point was a comparison of the number of days with all blood glucose measurements within the range of 70–180 mg/dL throughout a 24-hour period. Secondary end points included the number of hyperglycemic (>180 mg/dL) and hypoglycemic (<70 mg/dL) events that occurred in each study group. Group 1 included 101 individuals who received once-daily dosing, and group 2 included 103 individuals who received twice-daily dosing. Baseline characteristics were similar between the groups except for a higher BMI at admission (P = 0.01) and a higher pre-admission A1C (P = 0.02) in group 2. No differences were found for the primary end point (P = 0.5) or for hypoglycemic (P = 0.6) or hyperglycemic (P = 0.7) events. There were no significant differences in efficacy or safety between once-daily and twice-daily insulin glargine in the noncritically ill population. A larger prospective study could confirm these results.
非危重病人每日一次与每日两次胰岛素格拉贡剂量的回顾性分析
胰岛素是医院糖尿病治疗的首选。关于每日一次与每日两次格列卫胰岛素在医院的疗效和安全性存在一些争议,尤其是在重症患者中。 本试验研究的目的是评估在非危重病人中每日一次与每日两次胰岛素格列卫的疗效和安全性。 研究对 2020 年 6 月 1 日至 2021 年 5 月 31 日期间的病历进行了回顾性分析。纳入标准为年龄≥18岁,在规定时间内使用格列卫胰岛素每日一次或每日两次方案≥72小时。主要终点是比较 24 小时内所有血糖测量值均在 70-180 毫克/分升范围内的天数。次要终点包括各研究组发生高血糖(>180 毫克/分升)和低血糖(<70 毫克/分升)事件的次数。 第一组包括101名每日服药一次的患者,第二组包括103名每日服药两次的患者。除了第 2 组入院时的体重指数较高 (P = 0.01) 和入院前的 A1C 较高 (P = 0.02) 外,两组的基线特征相似。在主要终点 (P = 0.5) 或低血糖 (P = 0.6) 或高血糖 (P = 0.7) 事件方面均未发现差异。 在非危重病人群中,每日一次和每日两次的格列卫胰岛素在疗效和安全性方面没有明显差异。更大规模的前瞻性研究可以证实这些结果。
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来源期刊
Diabetes Spectrum
Diabetes Spectrum Medicine-Internal Medicine
CiteScore
2.70
自引率
0.00%
发文量
62
期刊介绍: The mission of Diabetes Spectrum: From Research to Practice is to assist health care professionals in the development of strategies to individualize treatment and diabetes self-management education for improved quality of life and diabetes control. These goals are achieved by presenting review as well as original, peer-reviewed articles on topics in clinical diabetes management, professional and patient education, nutrition, behavioral science and counseling, educational program development, and advocacy. In each issue, the FROM RESEARCH TO PRACTICE section explores, in depth, a diabetes care topic and provides practical application of current research findings.
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