Insulin in Total Parenteral Nutrition

Subcutaneous Versus Intravenous Basal Insulin in Non-critical Hospitalized Diabetic Patients That Receive Total Parenteral Nutrition

Analyze the level of metabolic control achieved with a routine of regular insulin in the parenteral nutrition (PN) reservoir in addition to subcutaneous glargine insulin, versus only regular insulin in the PN reservoir.

A pattern of basal insulin (using subcutaneous insulin glargine and regulating the stock as prandial), plus regular subcutaneous insulin as rescue, applied to total parenteral nutrition (TPN) should be as effective (glycemic control, variability) and safe (hypoglycemia) as the usual (regular insulin inside the TPN reservoir and subcutaneous insulin as rescue) in patients with type 2 diabetes critics.

Inclusion Criteria:

• Adults (>18 years)
• Previously diagnosed with diabetes mellitus.
• Hospitalized but without intensive cares.
• Have indication of total parenteral nutritional support (TPN, meaning the covering over 70% of the estimated daily requirements intravenously) for a minimum of 5 days.
• Signature of informed consent.

Exclusion Criteria:

• Diabetes mellitus type 1, diabetes secondary to total pancreatectomy.
• Patients with intensive cares.
• Patients who have been prescribed TPN in intensive cares unity more than 48 hours before admission to hospitalization.
• Intradialytic parenteral nutrition.
• Patients under 18 or pregnant women.
• Patients with renal insufficiency stage 3 B (glomerular filtration rate < 45 mL / min).