Point-of-Care Glucose Testing and Insulin Supplementation
Status:
Completed
Trial end date:
2013-12-01
Target enrollment:
Participant gender:
Summary
Capillary point-of-care (POC) testing is advocated as a valuable aid in the management of
diabetes and hyperglycemia in the hospital setting. POC testing aims at collecting
information on BG levels at different time points during the day in order to assess glycemic
control and to guide insulin adjustment/correction doses. Although POC testing provides
insights into day-to-day excursions in BG levels, bedtime BG testing triggers the use of
insulin supplements that may result in increased frequency of hypoglycemia and is expensive
with an estimated annual cost in hospitals of several hundreds of millions of dollars in the
U.S. Accordingly, this pilot study aims to assess the utility of POC and insulin
supplementation (correction doses) at bedtime in improving glycemic control and in preventing
hypoglycemia in non-ICU patients with type 2 diabetes mellitus (T2DM). A total of 250 non-ICU
medical and surgical patients treated with basal bolus regimen will undergo POC testing
before meals and bedtime (standard of care) and half of the patients will receive insulin
correction doses at bedtime for BG > 140 mg/dL following a sliding scale protocol, while the
other half will be followed without insulin supplementation at bedtime except for extreme
hyperglycemia (BG > 350 mg/dl). Patients will be recruited at Emory University Hospital and
Grady Memorial Hospital.