Insulin Therapy in the Hospital Comparing Two Protocols

Basal/Bolus Insulin Therapy in the Hospital Ward Comparison of Two Protocols: Feasibility Study

The purpose of this study is to determine if by using insulin analog (Glargine and lispro insulin) with an insulin pen the investigators are able to obtain a higher rate of correct timing of insulin and food administration as when compared to the usual therapy (insulin NPH and regular) with syringes.

Inclusion Criteria:

• Uncontrolled blood sugar:

  • Random blood sugar ≥ 200mg/dl
  • Pre-prandial blood sugar greater than 180 mg/dl on two occasions within 24 hours.

• Patient may be off insulin or on subcutaneous inpatient insulin regimen less than 36 hours.

• Transition from an Insulin Drip in the intensive care units to subcutaneous insulin upon transfer to general ward.

• Patient is able to eat and oral feeding is expected.

Exclusion Criteria:

• Patients receiving inpatient oral hypoglycemic agents
• Patients with chronic kidney disease stages 4 & 5 (estimated GFR of <30ml/min) and on dialysis
• Patient with chronic liver disease
• Patient with hypoglycemia unawareness
• Pregnancy
• Patients who are on "NPO" for medical reasons.
• Patient is expected to stay in the hospital for less than 3 days.
• Patient on a new inpatient insulin regimen for > 36 hours.