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Feasibility and safety of multiple daily insulin injections in general medicine wards

Andreas E Buchs1, Renske Bloemers, Eli Shiloah

  • 1Department of Internal Medicine C, Assaf Harofe Medical Center, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Zerifin, Israel. aebuchs@yahoo.com

European Journal of Internal Medicine
|June 16, 2009
PubMed
Abstract

Insights

Multiple daily subcutaneous insulin injections (MDI) are feasible, safe, and effective for managing blood glucose in diabetic patients hospitalized in general medical wards, improving clinical outcomes.

Area of Science:

  • Internal Medicine
  • Endocrinology
  • Diabetes Management

Background:

  • Intravenous insulin improves outcomes in intensive care units.
  • The efficacy of multiple daily subcutaneous insulin injections (MDI) in general medical wards is not well-established.
  • Hospitalized diabetic patients require effective glucose management strategies.

Purpose of the Study:

  • To assess the feasibility, safety, and efficacy of MDI for glucose control in diabetic patients on general medicine wards.
  • To compare conservative versus intensified MDI protocols.

Main Methods:

  • Eighty-eight adult diabetic patients were enrolled in an internal medicine department.
  • Patients received subcutaneous pre-meal insulin analogue and Glargin insulin.
  • Two protocols were tested: conservative and intensified.

Main Results:

  • Mean daily glucose levels significantly decreased in both conservative and intensified MDI groups.
  • The intensified protocol achieved target glucose levels (<180 mg%) faster and more consistently.
  • Only one serious hypoglycemic event occurred in the intensified group, indicating a favorable safety profile.

Conclusions:

  • Intensive insulin treatment with MDI is a feasible and safe approach for hospitalized diabetic patients in general medical wards.
  • MDI demonstrates efficacy in improving glucose control during hospitalization.
  • This strategy offers a viable alternative to intravenous insulin in non-critical care settings.

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