Use of NPH Versus Basal Bolus Insulin for Steroid Induced Hyperglycemia

• Status: Terminated
• Trial end date: 2019-08-15
• Target enrollment: 0
• Participant gender: All

Summary

Glucocorticoids are known to cause an increase in insulin resistance, leading to hyperglycemia, in both diabetic and non-diabetic patients. In both the inpatient and outpatient setting, steroids are used for their anti-inflammatory property to treat a variety of conditions. There is a paucity of information regarding the best way to treat steroid-induced hyperglycemia. In this study we will compare (1) the addition of NPH insulin, an intermediate-acting insulin, given at the time of steroid administration to the patient's standard basal/bolus insulin to (2) modification of the standard basal-bolus insulin regimen which will consist primarily increasing the prandial doses at lunch and supper in order to determine which regimen is superior for glycemic control.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Northwestern University
• Treatments: Insulin; Insulin Aspart; Insulin Glargine; Insulin, Globin Zinc; Insulin, Isophane; Isophane insulin, beef; Isophane Insulin, Human; Prednisone

Criteria

Inclusion Criteria:

• Patients receiving once daily dosing of methylprednisolone or prednisone in a dose of 10 mg/day or greater

• Hyperglycemic (Glucose level > 126 mg/dL)

• Diabetic and nondiabetic patients

• Expected duration of hospital stay and time on steroids >= 3 days

• Patient of appropriate caregiver able to give Informed Consent

Exclusion Criteria:

• Patients with 2 or more doses of methylprednisolone/prednisone per day

• Steroids other than methylprednisolone or prednisone

• Pregnancy

• estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73m2