NCT00911625
Glargine Dosing in Hospitalized Patients With Type 2 Diabetes and Renal Insufficiency
PHASE4
COMPLETED
NCT00911625
INTERVENTIONAL
Glargine Dosing in Hospitalized Patients With Type 2 Diabetes and Renal Insufficiency
It is imperative to devise easy to follow, yet appropriate, guidelines for insulin use in renal-impaired patients. This will be done by comparing two regimens: 1) glargine once daily plus mealtime glulisine based on weight alone and 2) a predetermined dosing reduction algorithm with glargine/glulisine based on weight with reduction for decreased estimated GFR by MDRD as follows: < 30 ml/min/1.73m2 or on dialysis reduce dose by 50% from weight based calculation.
Inclusion Criteria:
* Type 2 Diabetes Mellitus of mor than 1year
* GFR less than 30 ml/min/1.73m2 or dialysis
* Age greater than 18years
* Entry blood glucose (fasting or random) greater than 180mg%
Exclusion Criteria:
* Type 1 Diabetes Mellitus
* New onset hyperglycemia
* Pregnant
* Solid organ transplant within 1 year
* Steroids prednisone greater than 7.5mg/day or equivalent
* Hospital LOS predicted less than 2 days
* Severe liver disease
* Known hypopituitarism or adrenal insufficiency
* Patients in the ICU
* Patients with hypoglycemic unawareness
* Outpatient insulin dose less than 0.6 units/kg
Type 2 Diabetes
Renal Insufficiency
- TREATMENT
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- Type: DRUG
- Name: 0.5 units/kg daily insulin
- Description: Participants randomized to receive this intervention will receive a standard-dose of 0.5 units/kg daily insulin. Half of this dose will be given as glargine and the other half will be given as glulisine.
- Arm Group Labels: 0.5 units/kg
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- Type: DRUG
- Name: 0.25 units/kg daily insulin
- Description: Participants randomized to receive this intervention will receive an experimental dose of 0.25 units/kg daily insulin. Half of this dose will be given as glargine and the other half will be given as glulisine.
- Arm Group Labels: 0.25 units/kg
- Loyola University