Effect of the Concomitant Use of Subcutaneous Basal Insulin and Intravenous Insulin Infusion in the Treatment of Severe Hyperglycemic Patients

임예지; 온정훈; 정주; 류지원; 김선욱; 조재호; 박희선; 김혜원; 이종찬; 김은선; 김낙현; 조유환; 장학철

doi:https://doi.org/10.3803/EnM.2021.1341

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자료유형: 학술저널

저자정보: 임예지 (분당서울대학교병원) 온정훈 (서울대학교) 정주 (분당서울대학교병원) 류지원 (서울대학교) 김선욱 (서울대학교 의과대학 내과학교실) 조재호 (Hospital Medicine Center Seoul National University Bundang Hospital Korea) 박희선 (Hospital Medicine Center Seoul National University Bundang Hospital Korea) 김혜원 (Hospital Medicine Center Seoul National University Bundang Hospital Korea) 이종찬 (Hospital Medicine Center Seoul National University Bundang Hospital Korea) 김은선 (Hospital Medicine Center Seoul National University Bundang Hospital Korea) 김낙현 (Hospital Medicine Center Seoul National University Bundang Hospital Korea) 조유환 (분당서울대학교병원 응급의학과) 장학철 (분당서울대학교병원)

저널정보: 대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.37 No.3

발행연도: 2022.6

수록면: 444 - 454 (11page)

DOI: https://doi.org/10.3803/EnM.2021.1341

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Background: No consensus exists regarding the early use of subcutaneous (SC) basal insulin facilitating the transition from continuous intravenous insulin infusion (CIII) to multiple SC insulin injections in patients with severe hyperglycemia other than diabetic ketoacidosis. This study evaluated the effect of early co-administration of SC basal insulin with CIII on glucose control in patients withsevere hyperglycemia. Methods: Patients who received CIII for the management of severe hyperglycemia were divided into two groups: the early basal insulin group (n=86) if they received the first SC basal insulin 0.25 U/kg body weight within 24 hours of CIII initiation and ≥4 hoursbefore discontinuation, and the delayed basal insulin group (n=79) if they were not classified as the early basal insulin group. Rebound hyperglycemia was defined as blood glucose level of >250 mg/dL in 24 hours following CIII discontinuation. Propensityscore matching (PSM) methods were additionally employed for adjusting the confounding factors (n=108). Results: The rebound hyperglycemia incidence was significantly lower in the early basal insulin group than in the delayed basal insulin group (54.7% vs. 86.1%), despite using PSM methods (51.9%, 85.2%). The length of hospital stay was shorter in the early basal insulin group than in the delayed basal insulin group (8.5 days vs. 9.6 days, P=0.027). The hypoglycemia incidence did not differbetween the groups. Conclusion: Early co-administration of basal insulin with CIII prevents rebound hyperglycemia and shorten hospital stay withoutincreasing the hypoglycemic events in patients with severe hyperglycemia.

#Insulin #long-acting #Hyperglycemia #Diabetes complications #Diabetic ketoacidosis

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임예지

소속기관 분당서울대학교병원

주요연구분야 의약학 > 의학 일반 의약학 > 임상의학 > 내과학

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온정훈

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주요연구분야 의약학 > 의학 일반 의약학 > 임상의학 > 내과학

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정주

소속기관 분당서울대학교병원

주요연구분야 의약학 > 의학 일반 의약학 > 임상의학 > 내과학

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류지원

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주요연구분야 의약학 > 임상의학 > 내과학

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김선욱

소속기관 성균관대학교

주요연구분야 의약학 > 임상의학 > 내과학

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