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Updated: Apr 16, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Transitioning safely from intravenous to subcutaneous insulin
Kathryn Evans Kreider1, Lillian F Lien
1Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Duke University Medical Center, Box 3922, Durham, NC, 27710, USA, kathryn.evans@duke.edu.
Abstract:
The transition from intravenous (IV) to subcutaneous (SQ) insulin in the hospitalized patient with diabetes or hyperglycemia is a key step in patient care. This review article suggests a stepwise approach to the transition in order to promote safety and euglycemia. Important components of the transition include evaluating the patient and clinical situation for appropriateness, recognizing factors that influence a safe transition, calculation of proper SQ insulin doses, and deciding the appropriate type of SQ insulin. This article addresses other clinical situations including the management of patients previously on insulin pumps and recommendations for patients requiring glucocorticoids and enteral tube feedings. The use of institutional and computerized protocols is discussed. Further research is needed regarding the transition management of subgroups of patients such as those with type 1 diabetes and end-stage renal disease.
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