{"id":17826,"date":"2021-06-24T17:45:11","date_gmt":"2021-06-24T15:45:11","guid":{"rendered":"https:\/\/www.glucotab.at\/?p=17826"},"modified":"2022-11-24T16:02:19","modified_gmt":"2022-11-24T14:02:19","slug":"efficient-and-safe-glycaemic-control-with-basal-bolus-insulin-therapy-during-fasting-periods-in-hospitalized-patients-with-type-2-diabetes-using-decision-support-technology-a-post-hoc-analysis","status":"publish","type":"post","link":"https:\/\/www.glucotab.at\/en\/efficient-and-safe-glycaemic-control-with-basal-bolus-insulin-therapy-during-fasting-periods-in-hospitalized-patients-with-type-2-diabetes-using-decision-support-technology-a-post-hoc-analysis\/","title":{"rendered":"Efficient and safe glycaemic control with basal-bolus insulin therapy during fasting periods in hospitalized patients with type 2 diabetes using decision support technology: A post hoc analysis"},"content":{"rendered":"

Diabetes Obes Metab. 2021 Jun 3. 
doi: 10.1111\/dom.14458<\/a><\/p>\n

Aim:\u00a0<\/strong>To evaluate the efficacy and safety of basal-bolus insulin therapy in managing glycaemia during fasting periods in hospitalized patients with type 2 diabetes.<\/p>\n

<\/p>\n

Materials and methods: <\/strong>We performed a post hoc analysis of two prospective, uncontrolled interventional trials that applied electronic decision support system-guided basal-bolus (meal-related and correction) insulin therapy. We searched for fasting periods (invasive or diagnostic procedures, medical condition) during inpatient stays. In a mixed model analysis, patients’ glucose levels and insulin doses on days with regular food intake were compared with days with fasting periods.<\/p>\n

Results: <\/strong>Out of 249 patients, 115 patients (33.9% female, age 68.3 \u00b1 10.3 years, diabetes duration 15.1 \u00b1 10.9 years, body mass index 30.1 \u00b1 5.4 kg\/m2<\/sup> , HbA1c 69 \u00b1 20 mmol\/mol) had 194 days with fasting periods. Mean daily blood glucose (BG) was lower (modelled difference [ModDiff]: -0.5 \u00b1 0.2 mmol\/L, P = .006), and the proportion of glucose values within the target range (3.9-10.0 mmol\/L) increased on days with fasting periods compared with days with regular food intake (ModDiff: +0.06 \u00b1 0.02, P = .005). Glycaemic control on fasting days was driven by a reduction in daily bolus insulin doses (ModDiff: -11.0 \u00b1 0.9 IU, P < .001), while basal insulin was similar (ModDiff: -1.1 \u00b1 0.6 IU, P = .082) compared with non-fasting days. Regarding hypoglycaemic events (BG < 3.9 mmol\/L), there was no difference between fasting and non-fasting days (\u03c72<\/sup> 0.9% vs. 1.7%, P = .174).<\/p>\n

Conclusions: <\/strong>When using well-titrated basal-bolus insulin therapy in hospitalized patients with type 2 diabetes, the basal insulin dose does not require adjustment during fasting periods to achieve safe glycaemic control, provided meal-related bolus insulin is omitted and correction bolus insulin is tailored to glucose levels.<\/p>\n

Authors<\/h3>\n

Daniel A Hochfellner 1<\/sup>, Raphael Rainer 1<\/sup>, Haris Ziko 1<\/sup>, Felix Aberer 1<\/sup>, Amra Simic 1<\/sup>, Katharina M Lichtenegger 1<\/sup>, Peter Beck 2, 3<\/sup>, Klaus Donsa 3<\/sup>, Thomas R Pieber 1, 3<\/sup>, Friedrich M Fruhwald 4<\/sup>, Alexander R Rosenkranz 5<\/sup>, Lars-Peter Kamolz 6<\/sup>, Petra M Baumann 1<\/sup>, Julia K Mader 1<\/sup>, Johannes Plank 7<\/sup><\/p>\n

Affiliations<\/h3>\n
    \n
  1. Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.<\/li>\n
  2. Decide Clinical Software GmbH, Graz, Austria.<\/li>\n
  3. HEALTH, Joanneum Research GmbH, Graz, Austria.<\/li>\n
  4. Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.<\/li>\n
  5. Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.<\/li>\n
  6. Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.<\/li>\n
  7. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Diabetes Obes Metab. 2021 Jun 3. doi: 10.1111\/dom.14458 Aim:\u00a0To evaluate the efficacy and safety of basal-bolus insulin therapy in managing glycaemia during fasting periods in hospitalized patients with type 2 diabetes.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[4],"tags":[],"class_list":["post-17826","post","type-post","status-publish","format-standard","hentry","category-publications"],"_links":{"self":[{"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/posts\/17826","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/comments?post=17826"}],"version-history":[{"count":3,"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/posts\/17826\/revisions"}],"predecessor-version":[{"id":18002,"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/posts\/17826\/revisions\/18002"}],"wp:attachment":[{"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/media?parent=17826"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/categories?post=17826"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.glucotab.at\/en\/wp-json\/wp\/v2\/tags?post=17826"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}