Glycemic control with regular versus lispro insulin sliding scales in hospitalized Type 2 diabetics

Purpose: The aim of this study was to compare glycemic control with either regular or lispro insulin sliding scales in hospitalized Type 2 diabetics who were not using insulin as outpatients. Methods: Forty-three patients with Type 2 diabetes, who were taking oral agents only, were admitted to a medical inpatient service and randomized to receive either regular or lispro insulin sliding scale. Oral agents for diabetes were held upon admission and patients were followed throughout their hospital stay. Results: There was no significant difference (P>.05) between the average finger-stick blood glucose (FSBG) in the regular insulin group (157.78±40.16 mg/dl) and the lispro insulin group (152.04±27.71 mg/dl). No significant difference was found between the daily dose of insulin (regular, 5.83±5.01 units; lispro, 4.27±3.40 units), total amount of insulin used during hospitalization (regular, 11.87±10.78 units; lispro, 12.77±14.39 units), glucose excursion (regular, 110.13±25.86 mg/dl; lispro, 106.77±52.65 mg/dl), or length of hospital stay (regular, 2.33±1.23 days; lispro, 2.69±1.59 days). Conclusion: No significant difference in glycemic control was found in hospitalized Type 2 diabetic patients who received either regular or lispro insulin sliding scales. Both insulin sliding scales used in this study are inadequate to achieve current recommended glycemic targets in this patient population, when used as the only inpatient treatment for diabetes.