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Evaluation of Glycemic Control Using NPH Insulin Sliding Scale Versus Insulin Aspart Sliding Scale in Continuously Tube‐Fed Patients
Author(s) -
Cook Amber,
Burkitt Dora,
McDonald Lynn,
Sublett Laurie
Publication year - 2009
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533609351531
Subject(s) - medicine , glycemic , insulin aspart , insulin , nph insulin , hypoglycemia , insulin glargine
Background: Hyperglycemia is often a problem in patients who receive continuous enteral nutrition. The purpose of this study was to determine if the use of sliding‐scale neutral protamine Hagedorn (NPH) insulin was more effective than sliding‐scale insulin aspart in controlling blood glucose in continuously tube‐fed patients. Methods: A retrospective, records‐based review comparing sliding‐scale NPH insulin given every 4 or 6 hours with sliding‐scale insulin aspart was performed in patients admitted to 2 community hospitals between April 1, 2006, and September 30, 2007. Results: Mean blood glucose was found to be lower in patients receiving NPH every 4 hours and NPH every 6 hours than in patients receiving insulin aspart ( P < .001). No statistically significant differences in mean blood glucose values ( P = .41) were observed between patients receiving the NPH regimen given every 4 or 6 hours. More patients in the NPH groups had blood glucose values in the target and acceptable ranges than those in the insulin aspart group ( P < .001), but no statistical significance was observed between the groups receiving NPH every 4 hours and NPH every 6 hours ( P = .41). Conclusions: In this study, sliding‐scale NPH insulin was demonstrated to be a safe and effective management strategy for blood glucose control in continuously tube‐fed patients; NPH insulin resulted in better blood glucose control compared with insulin aspart.