A retrospective review of insulin requirements in patients using U-500 insulin hospitalized to a Veterans Affairs Hospital

Research output: Contribution to journalArticle

Abstract

Aims The aim of this study was to compare the changes in the total daily dose (TDD) of insulin of patients on U-500 insulin; before hospitalization, during hospitalization and six weeks after discharge. Methods A retrospective chart review of veterans with type 2 diabetes receiving U-500 insulin in the ambulatory setting and who were admitted between 2012 and 2015 was performed. During hospitalization, patients were transitioned to receive U-100 insulin (detemir or glargine for basal and aspart for bolus). Paired t-tests were conducted to compare TDD of insulin during hospitalization to prior to admission and at six week of follow-up. Results The average hemoglobin A1c at the time of hospital admission was 8.3 ± 1.5% (n = 20). The average TDD of insulin during hospitalization (124 ± 67 units) was significantly less than prior to admission (295 ± 123 units) and at six week follow-up (310 ± 105 units). The average glucose during hospitalization was 180 ± 36 mg/dL. Hypoglycemia was less than 0.5%. Conclusion We showed that patients received significantly less total daily insulin while hospitalized compared to their insulin doses in the ambulatory setting, and we demonstrate that patients receiving U-500 insulin can be safely transitioned to U-100 insulin while hospitalized, with minimal hypoglycemia.

Original languageEnglish (US)
Pages (from-to)874-879
Number of pages6
JournalJournal of Diabetes and Its Complications
Volume31
Issue number5
DOIs
StatePublished - May 2017

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Veterans Hospitals
Insulin
Hospitalization
Hypoglycemia
Veterans
Type 2 Diabetes Mellitus
Hemoglobins
Glucose

Keywords

  • Hospitalization
  • Hypoglycemia
  • Insulin resistance
  • U-500 insulin
  • Veteran

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

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title = "A retrospective review of insulin requirements in patients using U-500 insulin hospitalized to a Veterans Affairs Hospital",
abstract = "Aims The aim of this study was to compare the changes in the total daily dose (TDD) of insulin of patients on U-500 insulin; before hospitalization, during hospitalization and six weeks after discharge. Methods A retrospective chart review of veterans with type 2 diabetes receiving U-500 insulin in the ambulatory setting and who were admitted between 2012 and 2015 was performed. During hospitalization, patients were transitioned to receive U-100 insulin (detemir or glargine for basal and aspart for bolus). Paired t-tests were conducted to compare TDD of insulin during hospitalization to prior to admission and at six week of follow-up. Results The average hemoglobin A1c at the time of hospital admission was 8.3 ± 1.5{\%} (n = 20). The average TDD of insulin during hospitalization (124 ± 67 units) was significantly less than prior to admission (295 ± 123 units) and at six week follow-up (310 ± 105 units). The average glucose during hospitalization was 180 ± 36 mg/dL. Hypoglycemia was less than 0.5{\%}. Conclusion We showed that patients received significantly less total daily insulin while hospitalized compared to their insulin doses in the ambulatory setting, and we demonstrate that patients receiving U-500 insulin can be safely transitioned to U-100 insulin while hospitalized, with minimal hypoglycemia.",
keywords = "Hospitalization, Hypoglycemia, Insulin resistance, U-500 insulin, Veteran",
author = "Rohit Kedia and Desouza, {Cyrus V} and Smith, {Lynette M} and Vijay Shivaswamy",
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AU - Desouza, Cyrus V

AU - Smith, Lynette M

AU - Shivaswamy, Vijay

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N2 - Aims The aim of this study was to compare the changes in the total daily dose (TDD) of insulin of patients on U-500 insulin; before hospitalization, during hospitalization and six weeks after discharge. Methods A retrospective chart review of veterans with type 2 diabetes receiving U-500 insulin in the ambulatory setting and who were admitted between 2012 and 2015 was performed. During hospitalization, patients were transitioned to receive U-100 insulin (detemir or glargine for basal and aspart for bolus). Paired t-tests were conducted to compare TDD of insulin during hospitalization to prior to admission and at six week of follow-up. Results The average hemoglobin A1c at the time of hospital admission was 8.3 ± 1.5% (n = 20). The average TDD of insulin during hospitalization (124 ± 67 units) was significantly less than prior to admission (295 ± 123 units) and at six week follow-up (310 ± 105 units). The average glucose during hospitalization was 180 ± 36 mg/dL. Hypoglycemia was less than 0.5%. Conclusion We showed that patients received significantly less total daily insulin while hospitalized compared to their insulin doses in the ambulatory setting, and we demonstrate that patients receiving U-500 insulin can be safely transitioned to U-100 insulin while hospitalized, with minimal hypoglycemia.

AB - Aims The aim of this study was to compare the changes in the total daily dose (TDD) of insulin of patients on U-500 insulin; before hospitalization, during hospitalization and six weeks after discharge. Methods A retrospective chart review of veterans with type 2 diabetes receiving U-500 insulin in the ambulatory setting and who were admitted between 2012 and 2015 was performed. During hospitalization, patients were transitioned to receive U-100 insulin (detemir or glargine for basal and aspart for bolus). Paired t-tests were conducted to compare TDD of insulin during hospitalization to prior to admission and at six week of follow-up. Results The average hemoglobin A1c at the time of hospital admission was 8.3 ± 1.5% (n = 20). The average TDD of insulin during hospitalization (124 ± 67 units) was significantly less than prior to admission (295 ± 123 units) and at six week follow-up (310 ± 105 units). The average glucose during hospitalization was 180 ± 36 mg/dL. Hypoglycemia was less than 0.5%. Conclusion We showed that patients received significantly less total daily insulin while hospitalized compared to their insulin doses in the ambulatory setting, and we demonstrate that patients receiving U-500 insulin can be safely transitioned to U-100 insulin while hospitalized, with minimal hypoglycemia.

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