Lama S. Alfehaid^1*, Abdulmalik S. Alotaibi², Ahmed S. Alanazi³, Rami T. Bustami⁴, Razan El Melik⁵

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¹ College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
² King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.
³ King Fahad Medical City, Riyadh, Saudi Arabia.
⁴ Alfaisal University, Riyadh, Saudi Arabia.
⁵ Mayo Clinic, Rochester, MN, USA.
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Abstract: Background: Hyperglycemia in hospitalized patients is managed through one of the following approaches: sliding scale insulin (SSI) alone; SSI plus long-acting insulin and basal-bolus insulin (BBI). The optimal insulin treatment regimen is still debated. Objectives: To evaluate the clinical outcomes associated with the use of SSI compared to other regimens. Setting: The general medical wards in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: Medical charts for adult patients admitted between October 2014-December 2015 with type 2 diabetes or uncontrolled hyperglycemia with insulin treatment were reviewed. Data from capillary blood glucose were measured daily for the first 5 days of hospitalization and recorded. Demographics and blood glucose levels were compared by group using one-way ANOVA or Chi-square test. The number of hyperglycemic/hypoglycemic episodes was analyzed using the Kruskal-Wallis test. Results: A total of 240 patients were included. The three insulin regimen groups were not statistically different in terms of the number of days with episodes of hyper- or hypoglycemia (p > 0.05). However, a significantly bigger change from baseline (improvement) in random blood glucose (RBG) levels was observed in BBI and SSI plus glargine patients compared to SSI (p = 0.014). Conclusion: Our study showed no significant difference in the number of days with episodes of hyper- or hypoglycemia for SSI vs. other insulin regimens. However, SSI patients had less improvement in their RBG levels compared to other insulin regimen groups. Further studies with a larger sample size are needed to confirm these findings.

Keywords: Subcutaneous Sliding Scale Insulin, Hyperglycemia, Hospitalized Patients

Cite this paper: Alfehaid, L. , Alotaibi, A. , Alanazi, A. , Bustami, R. and Melik, R. (2018) Clinical Outcomes Associated with Use of Subcutaneous Sliding Scale Insulin Compared to Other Insulin Regimens in Hospitalized Patients. International Journal of Clinical Medicine, 9, 260-269. doi: 10.4236/ijcm.2018.94023.

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