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Just As We Always Say ....

Posted Oct 23 2009 10:03pm
"Sliding Scale" insulin therapy, a favorite in the hospital setting, is rarely, if ever, adequate or appropriate. But, it has been maintained for decades and will likely continue.

The Medical Center of Plano (Texas) randomized non-critically ill, but hospitalized, patients into "sliding scale" and "tight control" groups. They chose 80-150 mg/dl as the target range for blood sugars and looked at the first 48 hours of admission.

There was an almost 50% higher rate of target blood glucose achievement in the non-"sliding scale" (NSS) group. Rates of hypoglycemia were higher in the NSS group, but none were considered significant.

The study abstract is
here.

We'll continue to cringe upon hearing that a hospitalized diabetic has been subjected tosliding scaleinsulin. Patients, however, should still expect to be subjected to this "inferior" method of managing diabetes in the hospital setting if not being managed by an endocrinologist or diabetologist.

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