The objective of this study is to determine the best insulin regimen for hospitalized patients who receive high doses of steroids who have high blood glucose.

The overall study objective of this research is to establish the efficacy and assure the safety of achieving glycemic control in hospitalized patients who receive greater than physiologic doses of steroids. This study will compare 2 methods of achieving glycemic control in hospitalized patients who develop steroid-induced hyperglycemia (blood glucose (BG) >180 mg/dL): 1) a study-specific steroid NPH dosing algorithm plus standard recommended care (Experimental group) vs. 2) the standard recommended care (Methodist Hospital Complete Insulin Orders (Control group).

Inclusion Criteria:

• Men or women aged ≥18 years who receive steroids in doses greater than physiologic replacement levels of ≥ 10 mg Prednisone or its equivalent of dexamethasone or methylprednisolone.
• Have signed the consent form for the study
• Have a BG > 180 mg/dL any time during the first 24 hour of steroid administration that is above physiological replacement ( ≥ 10 mg Prednisone or equivalent)
• Are scheduled to be in hospital ≥ 2 days.

Exclusion Criteria:

• Unable to read or understand English
• History of psychiatric disability affecting informed consent or compliance with drug intake
• Type 1 diabetes
• Acute or chronic renal failure (creatinine clearance < 30 mL/min estimated by method of Cockcroft and Gault)
• Patients in Hospice Care
• Age <18 years
• Previously enrolled in this study.
• Not appropriate for the steroid protocol in judgment of the principal investigator and/or attending physician.

Adverse event data collected over complete length of inpatient stay, up through 5 days.

All subjects glucose level tests were reviewed looking for incidence of severe hypoglycemia (< 50 mg/dL)