Insulin infusion therapy in critical care patients: Regular insulin vs short-acting insulin. A prospective, crossover, randomized, multicenter blind study

2015 ◽  
Vol 30 (2) ◽  
pp. 437.e1-437.e6 ◽  
Author(s):  
Federico Bilotta ◽  
Rafael Badenes ◽  
Simona Lolli ◽  
Francisco Javier Belda ◽  
Sharon Einav ◽  
...  
Keyword(s):  
Critical Care ◽  
Insulin Infusion ◽  
Regular Insulin ◽  
Blind Study ◽  
Infusion Therapy ◽  
Short Acting ◽  
Acting Insulin ◽  
Short Acting Insulin ◽  
Critical Care Patients

scholarly journals Addition of a single short-acting insulin bolus to basal insulin-supported oral therapy: a systematic review of data on the basal-plus regimen

2019 ◽  
Vol 7 (1) ◽  
pp. e000679 ◽  
Author(s):  
Jochen Seufert ◽  
Anja Borck ◽  
Peter Bramlage
Keyword(s):  
Basal Insulin ◽  
Fixed Ratio ◽  
Severe Hypoglycemia ◽  
Insulin Regimen ◽  
Premixed Insulin ◽  
Minimal Impact ◽  
Short Acting ◽  
Acting Insulin ◽  
Short Acting Insulin ◽  
Basal Bolus

We summarize here clinical and trial data on a once-daily administration of a single bolus to the meal with the largest expected postprandial glucose excursion (basal-plus), and comment on its clinical utility in the treatment of type 2 diabetes. A PubMed search of data published until September 2018 was taken into consideration and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eighteen reports representing 15 studies were identified (age: 18–80 years; 50–890 patients; follow-up: 8 days to 60 weeks). Data suggest basal-plus is efficacious for improving glycemic control, with a low incidence of (severe) hypoglycemia and minor increases in bodyweight. The timing of short-acting insulin administration and use of different monitoring/titration approaches appear to have minimal impact. When compared with premixed insulin, basal-plus results in largely comparable outcomes. Compared with basal-bolus, it may result in non-inferior glycemic improvements with less weight gain, less hypoglycemia and fewer daily injections. A basal insulin/glucagon-like peptide-1 receptor agonist fixed ratio combination may offer several advantages over the basal-plus regimen, at the cost of gastrointestinal side effects. We conclude that the stepwise introduction of short-acting insulin via the basal-plus strategy represents a viable alternative to a full basal-bolus regimen and may help to overcome barriers associated with multiple injections and anticipated complexity of the insulin regimen.

scholarly journals A Wasteful and Harmful Practice: Sliding Scale Insulin Use Among Nursing Home Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 205-206
Author(s):  
Kenneth Lam ◽  
Siqi Gan ◽  
Bocheng Jing ◽  
Brian Nguyen ◽  
Sei Lee
Keyword(s):  
Nursing Home ◽  
Linear Trend ◽  
Nursing Home Residents ◽  
Fixed Dose ◽  
Short Acting ◽  
Acting Insulin ◽  
Short Acting Insulin ◽  
Sliding Scale ◽  
Insulin Use ◽  
Variable Dose

Abstract The American Medical Directors Association and the American Diabetes Association discourage the use of sliding scale insulin (SSI) in nursing home residents with diabetes due to its association with hypoglycemia, hyperglycemia, nursing burden, and patient discomfort. However, prevalence of SSI use is unclear. We used Veterans Affairs (VA) data from October 2013 to September 2016 to determine the weekly prevalence of SSI among 22,847 veterans with diabetes admitted to VA nursing homes (NHs). Average age was 75.3 (SD 8.3) years, mean A1c was 7.3% (SD 1.6%) and 57% were admitted from hospital. We first identified residents receiving any short-acting insulin. We then classified short-acting insulin use into three mutually exclusive regimens: (1) fixed scheduled doses, (2) SSI, defined as a variable dose of short-acting insulin without a concurrent fixed dose or (3) bolus with correction (BWC), defined as a variable dose given concurrently with a fixed dose that day. During the first week of NH admission, 64.7% of residents with diabetes received no short-acting insulin, 7.4% received fixed scheduled doses, 6.3% received BWC and 21.4% were on SSI. At week 12, the prevalence of fixed dose and BWC regimens was unchanged from baseline (fixed dose = 8.4%; BWC = 7.0%). In contrast, the prevalence of SSI decreased weekly to 15.8% (p for linear trend < 0.0001). Although SSI prevalence decreased from week 1 to week 12, 51% of residents on short-acting insulin were still using SSI in their 12th week of their NH stay.

New insulins (June 10, 1966, p. 45) - corrections

1966 ◽  
Vol 4 (13) ◽  
pp. 52-52
Keyword(s):  
Short Acting ◽  
Protamine Zinc Insulin ◽  
Acting Insulin ◽  
Short Acting Insulin ◽  
Long Acting

This article stated that Actrapid and Nuso insulins can be mixed with protamine zinc insulin and other long-acting insulins. This is true, but we should have made it clear that in such a mixture the time-action characteristics of its components are likely to be altered, for some of the short-acting insulin is probably bound by the long-acting one.

scholarly journals The use of ultra-short acting insulin preparations for insulin pumps

2012 ◽  
Vol 58 (3) ◽  
pp. 46-50
Author(s):  
E A Andrianova
Keyword(s):  
Diabetes Mellitus ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Age Groups ◽  
Insulin Pump Therapy ◽  
Insulin Pumps ◽  
Pump Therapy ◽  
Short Acting ◽  
Acting Insulin ◽  
Short Acting Insulin

The data on the efficacy of using ultra-short acting insulin preparations in insulin pumps for children and adolescents presenting with diabetes mellitus. Insulin pump therapy in the patients of these age groups is finding an increasingly wider application as being more convenient for the users and leading to the improvement of glycemic control. One of the main advantages of modern insulin pump therapy is the possibility to maximally imitate the physiological profile of insulin secretion. The flexibility of both basal and bolus dosing regimens of insulin administration can be further increased by using ultra-short acting insulin preparations in insulin pumps. The choice of any of the three currently available analogs of ultra-short acting insulin guarantees their identical efficacy and safety in the children and adolescents with type 1 diabetes mellitus. They can be recommended as insulins of choice for the use in pump therapy

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