Basal Bolus Insulin Versus SSRI in Type 2 Diabetes Undergoing General Surgery
Status:
Completed
Trial end date:
2013-07-01
Target enrollment:
Participant gender:
Summary
High blood glucose levels in surgical patients with diabetes are associated with increased
risk of medical complications and death. Improved glucose control with insulin injections may
improve clinical outcome and prevent some of the hospital complications. In patients who have
undergone surgery, high blood glucose increases the risk of wound infection, kidney failure
and death. It is not known; however, what is the best insulin regimen in patients who will
undergo surgery. The use of repeated injections of regular insulin is commonly used for
glucose control in hospitalized patients with diabetes. Recently, the combination of Lantus®
and Apidra® insulins has been shown to improve glucose control with lower rate of
hypoglycemia (low blood sugar). We hypothesize that in patients with type 2 diabetes admitted
to general surgery wards, treatment with once daily glargine (Lantus) plus supplemental
glulisine insulin (Apidra®) will produce better glycemic control and a lower rate of hospital
complications than treatment with regular insulin per sliding scale (SSRI). The present study
aims to determine which insulin treatment is best for glucose control in hospitalized
patients with diabetes. Glargine and glulisine insulins are approved for use in the treatment
of patients with diabetes by the FDA.
Subjects included in the study will have type 2 diabetes and be admitted to Grady Memorial
Hospital, Veterans Administration Medical Center, and Emory University Hospital, Atlanta,
Georgia. A total of ~94 patients will be recruited at each institution.
A post-hoc cost analysis of hospitalization costs and charges of the Rabbit surgery trial
will be completed in order to determine differences in hospitalization cost between basal
bolus insulin and SSI regimen.