Objectives: Although the efficacy of basal-bolus insulin regimen (BBI) in type 2 diabetes (T2D) patients has been demonstrated in clinical studies, few studies have revealed changes in glycemic control following the introduction of BBI in hospital practice. This study was aimed to evaluate the effect of structured BBI in clinical practice for hospitalized patients with T2D.
Methods: We retrospectively analyzed non-critically ill T2D patients treated with insulin, who were hospitalized for glycemic control at Seoul National University Hospital (SNUH) from 2004 to 2018. The effects of BBI in T2D patients after 2007, when the current BBI protocol was introduced to SNUH, compared to that of the other types of insulin in T2D patients until 2007. Patients were propensity-score-matched in a 1:1 ratio.
Results: Among 294 BBI treated patients (age, 60.4 ± 13.8 years; male, 141 [48.0%]; HbA1c, 10.4 ± 1.9%) and 294 other insulin-treated patients (age, 59.9 ± 12.6 years; male, 148 [50.3%]; HbA1c, 10.3 ± 1.9%), mean admission pre-prandial blood glucose level were 181.0 ± 37.7 mg/dl and 200.0 ± 34.0 mg/dl, respectively (P <0.05). Blood glucose target of <140 mg/dl was achieved in 56.1% of patients in the BBI group and in 33.7% of those in the other insulin group on the sixth day of admission. The mean first target achievement day was 3.6 ± 1.3 days in the BBI group and 4.2 ± 1.5 days in other insulin groups, respectively (P <0.05). Events of hypoglycemia (≤70 mg/dL) and severe hypoglycemia (<55 mg/dL) were not different between the groups.
Conclusion: In this study of clinical practice in a tertiary hospital, structured BBI showed significantly improved glycemic control compared to other types of insulin regimens for T2D patients.
S. Moon: None. H. Jang: None. Y. Yang: None. S. Kwak: None. H. Jung: None. K. Park: None. Y. Cho: None.