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Updated: Dec 13, 2025

Improving IV Insulin Administration in a Community Hospital

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Published on: June 11, 2012

The Insulin Regimen That Works.

Svitlana Crawley¹, Susan Chaney²

¹University of Colorado School of Medicine, Aurora, Colorado Svitlana.Crawley@ucdenver.edu.

Journal of Doctoral Nursing Practice

|August 4, 2020

Summary

This summary is machine-generated.

Intensifying insulin therapy by adding rapid-acting insulin can improve glycemic control in type 2 diabetes patients. This approach helps achieve target HbA1c levels when basal insulin alone is insufficient.

Keywords:

basal insulin therapy basal-bolus insulin therapy basal-plus insulin therapy glycemic goals type 2 diabetes mellitus

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Area of Science:

Endocrinology
Diabetes Management

Background:

Type 2 diabetes mellitus necessitates diligent glycemic control monitoring.
Treatment escalation is crucial if glucose levels exceed target goals despite adherence to current therapies.
When glycosylated hemoglobin (HbA1c) targets remain unmet with maximal basal insulin and fasting glucose is at goal, adding rapid-acting insulin is indicated.

Purpose of the Study:

To present an effective strategy for intensifying insulin therapy.
The method focuses on individual patient needs and self-management capabilities.

Main Methods:

A retrospective case review was conducted.
The case involved a patient referred to an Endocrinology Specialty Clinic for diabetes management.

Main Results:

Intensifying insulin therapy by incorporating once-daily rapid-acting insulin injections led to improved diabetes control.
The patient's overall diabetes management showed positive results after the treatment adjustment.

Conclusions:

Adding a single daily dose of rapid-acting insulin before meals can effectively lower HbA1c to below 7%.
This strategy is beneficial for patients on maximum basal insulin doses with controlled fasting glucose but elevated HbA1c.
Early intensification of antihyperglycemic therapy, aligned with ADA guidelines, is vital for reducing complication risks and achieving glycemic goals.