Related Experiment Video
Updated: Jun 1, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
A National Physician Survey Examining Switching From Sulfonylureas or Insulin to Newer Diabetes Medications
Scott J Pilla1,2,3, Isabelle J Wang1, Olive Tang4
1Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract:
This study was a national survey of U.S. physicians in general medicine, geriatrics, or endocrinology who were asked what medication change they would make for adults with type 2 diabetes taking sulfonylureas or insulin with an A1C below their individualized goal. Responding physicians switched the hypoglycemia-causing medication a median of 4 times (interquartile range 1-9) among 27 opportunities and selected dipeptidyl peptidase 4 inhibitors most often when switching. Sodium-glucose cotransporter 2 inhibitors were selected less frequently, including when indicated for cardiovascular and renal comorbidities, but significantly more often among physicians caring for a greater proportion of patients with private health insurance. Overcoming barriers to switching hypoglycemia-causing medications may help to reduce rates of hypoglycemia while targeting cardiovascular and renal comorbidities.
Related Concept Videos
Oral Hypoglycemic Agents: Sulfonylureas
Oral Hypoglycemic Agents: Glinides
Oral Hypoglycemic Agents: Biguanides and Glitazones
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

