Efficient and safe glycaemic control with basal-bolus insulin therapy during fasting periods in hospitalized patients with type 2 diabetes using decision support technology: A post hoc analysis

Diabetes, Obesity and MetabolismHochfellner DA, Rainer R, Ziko H, et al. | June 24, 2021

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In this study, the efficacy and safety of basal-bolus insulin therapy in managing glycaemia during fasting periods in hospitalized patients with type 2 diabetes were explored. Researchers conducted a post hoc analysis of two prospective, uncontrolled interventional trials that applied electronic decision support system-guided basal-bolus (meal-related and correction) insulin therapy. Researchers carried out a search for fasting periods (invasive or diagnostic procedures, medical condition) during inpatient stays. The study enrolled a total of 249 patients, 115 patients (33.9% female, age 68.3 ± 10.3 years, diabetes duration 15.1 ± 10.9 years, body mass index 30.1 ± 5.4 kg/m 2 , HbA1c 69 ± 20 mmol/mol) had 194 days with fasting periods. The findings illustrate that the basal insulin dose does not require adjustment during fasting periods to achieve safe glycaemic control when using well-titrated basal-bolus insulin therapy in hospitalized patients with type 2 diabetes, provided meal-related bolus insulin is omitted and correction bolus insulin is tailored to glucose levels.

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