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What Is The Difference Between Basal And Bolus Insulin?

Basal Bolus Insulin Versus Ssri In Type 2 Diabetes Undergoing General Surgery (rabbit 2-sx)

Basal Bolus Insulin Versus Ssri In Type 2 Diabetes Undergoing General Surgery (rabbit 2-sx)

High blood glucose levels in surgical patients with diabetes are associated with increased risk of medical complications and death. Improved glucose control with insulin injections may improve clinical outcome and prevent some of the hospital complications. In patients who have undergone surgery, high blood glucose increases the risk of wound infection, kidney failure and death. It is not known; however, what is the best insulin regimen in patients who will undergo surgery. The use of repeated injections of regular insulin is commonly used for glucose control in hospitalized patients with diabetes. Recently, the combination of Lantus® and Apidra® insulins has been shown to improve glucose control with lower rate of hypoglycemia (low blood sugar). We hypothesize that in patients with type 2 diabetes admitted to general surgery wards, treatment with once daily glargine (Lantus) plus supplemental glulisine insulin (Apidra®) will produce better glycemic control and a lower rate of hospital complications than treatment with regular insulin per sliding scale (SSRI). The present study aims to determine which insulin treatment is best for glucose control in hospitalized patients with diabetes. Glargine and glulisine insulins are approved for use in the treatment of patients with diabetes by the FDA. Subjects included in the study will have type 2 diabetes and be admitted to Grady Memorial Hospital, Veterans Administration Medical Center, and Emory University Hospital, Atlanta, Georgia. A total of ~94 patients will be recruited at each institution. A post-hoc cost analysis of hospitalization costs and charges of the Rabbit surgery trial will be completed in order to determine differences in hospitalization cost between basal bolus insulin and SSI regimen. Study Type : Interve Continue reading >>

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® (insulin aspart injection) 100 U/mL is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus. NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is re Continue reading >>

Basal-bolus Insulin Therapy: How To Use It, Benefits, And Risks

Basal-bolus Insulin Therapy: How To Use It, Benefits, And Risks

Diabetes is a disease that affects the way the body produces and uses insulin to control blood sugar. Basal-bolus insulin therapy is an option for diabetes management that combines different types of short- and long-acting insulin. Doctors now call basal-bolus therapy intensive or flexible insulin therapy. This type of therapy is becoming less and less frequent because around 3040 percent of people with type 1 diabetes now use an automatic insulin pump and continuous glucose monitoring, which avoids the need for daily injections. However, switching between basal and bolus insulin doses at strategic times is the foundation for newer, automated diabetes care technologies. In a healthy person, the pancreas produces enough insulin for the bodys needs, whether it is active, resting, eating, sick, or sleeping. This means that people without diabetes can eat food at any time of the day without their blood sugar levels changing dramatically. However, people with diabetes cannot produce or use insulin effectively enough to control blood sugar. People with diabetes can use injections throughout the day to mimic the two types of insulin: Basal and bolus. Different types of insulin act for different durations and peak at different times. Basal bolus insulin therapy combines different insulins to manage blood sugar. Basal-bolus insulin therapy is an intensive insulin treatment that involves taking a combination of insulins. Some people might take only basal, or background insulin. This is a long-acting insulin that boosts activity for around 24 hours at a time, but to a lower peak than rapid-, intermediate-, or regular-acting insulin. Basal provides a constant supply of insulin to bring down high resting blood glucose levels. Bolus insulin, on the other hand, has a much more powerf Continue reading >>

Nursing Science Prevention, Education, And Disease Management 79. Basal-bolus Insulin Compared To Premixed Insulin In Cardiac Outpatients With Type 2 Diabetes

Nursing Science Prevention, Education, And Disease Management 79. Basal-bolus Insulin Compared To Premixed Insulin In Cardiac Outpatients With Type 2 Diabetes

Diabetes is a highly prevalent chronic disease worldwide. It was observed inKing Abdul-Aziz Cardiac Centre (KACC) that, subjects treated with basal bolus insulin showed better glycemic control than premixed insulin. Aim: To compare the efficacy and safety of basal-bolus insulin, to premixed insulin in subjects with type 2 diabetes. Retrospective, comparison, chart review study included all subjects with type 2 diabetes in KACC followed up in the Cardiac Diabetes Clinic, between 2010 and 2015, who are treated with basal bolus insulin or premixed insulin. Data including HbA1C, body weight, and hypoglycemia events, pre and 1 year post initiation of insulin therapy, will be extracted from all subject’s medical records. Results will be compared between the two groups and analyzed using SPSS. Data for 400 patients was collected and analyzed. Patients were divided into two groups, Group (A) who received premixed Insulin 70/30 and Group (B) which included all patients who received Basal Bolus Insulin (N 170). Group A included 230 patients, 72% of subject in this group were Female with mean age of 64 years (STD 10), with mean HbA1c of 9.6% pre insulin use compared to 9.1% one year later (p 0.001). Group (B) included 170 patients with 64% of them were male with mean age of 61 (STD 12), with mean HbA1c of 9.9% before the use of Basal bolus insulin compared to 9.1% one year later (p 0.001). However there was no significant difference in the effect of Premixed insulin compared to Basal Bolus insulin on HbA1c. The use of either Basal Bolus insulin or Premixed has similar significant effect on HbA1c. Continue reading >>

What Is Insulin? Everything To Know If You Have Diabetes

What Is Insulin? Everything To Know If You Have Diabetes

When you think about diabetes in a general sense, your mind might immediately flash to finger pricks. But while insulin therapy is common, it’s not for everyone who has been diagnosed with the disease. Indeed, according to the Centers for Disease Control and Prevention (CDC), only 18 percent of adults with the disease take insulin to manage diabetes, while 13 percent take insulin and oral medications. If you have type 2 diabetes, it’s important to understand the basics on insulin before making a decision with your doctor about whether you need it to control your blood sugar — including what it is, what it does, what its potential benefits are, and how to overcome the fear of finger pricks if you’ve been prescribed the therapy. What Does the Pancreas Do, and How Does Insulin Affect Blood Sugar Levels? The pancreas, a gland located deep in our abdomen, releases the hormone insulin. Insulin’s primary purpose is to help transport glucose, or blood sugar, to our liver, muscle, and fat cells to be used for energy or to be stored for later use, according to the National Institute of Diabetes and Digestive and Kidney Diseases. In people without diabetes, this process works smoothly, with the pancreas meeting the body’s demands for insulin and that sufficient insulin transporting glucose to cells. Consequently, blood sugar levels stay within a normal range. But when insulin resistance occurs, the body’s cells don’t respond correctly to insulin. With this condition — which can also occur in the absence of type 2 diabetes — the pancreas’s beta cells attempt to release more and more insulin to ferry glucose to cells. When beta cells aren’t able to meet the body’s demands for insulin, blood sugar accumulates, leading to diabetes and other health issues. How Continue reading >>

Randomized Study Of Basal-bolus Insulin Therapy In The Inpatient Management Of Patients With Type 2 Diabetes (rabbit 2 Trial)

Randomized Study Of Basal-bolus Insulin Therapy In The Inpatient Management Of Patients With Type 2 Diabetes (rabbit 2 Trial)

OBJECTIVE—We sought to study the optimal management of hyperglycemia in non–intensive care unit patients with type 2 diabetes, as few studies thus far have focused on the subject. RESEARCH DESIGN AND METHODS—We conducted a prospective, multicenter, randomized trial to compare the efficacy and safety of a basal-bolus insulin regimen with that of sliding-scale regular insulin (SSI) in patients with type 2 diabetes. A total of 130 insulin-naive patients were randomized to receive glargine and glulisine (n = 65) or a standard SSI protocol (n = 65). Glargine was given once daily and glulisine before meals at a starting dose of 0.4 units · kg−1 · day−1 for blood glucose 140–200 mg/dl or 0.5 units · kg−1 · day−1 for blood glucose 201–400 mg/dl. SSI was given four times per day for blood glucose >140 mg/dl. RESULTS—The mean admission blood glucose was 229 ± 6 mg/dl and A1C 8.8 ± 2%. A blood glucose target of <140 mg/dl was achieved in 66% of patients in the glargine and glulisine group and in 38% of those in the SSI group. The mean daily blood glucose between groups ranged from 23 to 58 mg/dl, with an overall blood glucose difference of 27 mg/dl (P < 0.01). Despite increasing insulin doses, 14% of patients treated with SSI remained with blood glucose >240 mg/dl. There were no differences in the rate of hypoglycemia or length of hospital stay. CONCLUSIONS—Treatment with insulin glargine and glulisine resulted in significant improvement in glycemic control compared with that achieved with the use of SSI alone. Our study indicates that a basal-bolus insulin regimen is preferred over SSI in the management of non–critically ill, hospitalized patients with type 2 diabetes. Hyperglycemia in hospitalized patients is a common, serious, and costly health car Continue reading >>

How To Manage Diabetes With Basal-bolus Insulin Therapy

How To Manage Diabetes With Basal-bolus Insulin Therapy

Diabetes is a disease that affects the way the body produces and uses insulin. Basal-bolus insulin therapy is a way of managing this condition. In type 1 diabetes, the production of insulin is affected. In type 2 diabetes, both the production and use of insulin are affected. In people without diabetes, insulin is produced by the pancreas to keep the body's blood sugar levels under control throughout the day. The pancreas produces enough insulin, whether the body is active, resting, eating, sick, or sleeping. This allows people without diabetes to eat food at any time of the day, without their blood sugar levels changing dramatically. For people with diabetes, this doesn't happen. However, a similar level of blood sugar control can be achieved by injecting insulin. Injections can be used throughout the day to mimic the two types of insulin: basal and bolus. People without diabetes produce these throughout the day and at mealtimes, respectively. What is a basal-bolus insulin regimen? A basal-bolus insulin regimen involves a person with diabetes taking both basal and bolus insulin throughout the day. It offers them a way to control their blood sugar levels. It helps achieve levels similar to a person without diabetes. Advantages There are several advantages to using a basal-bolus insulin regimen. These include: flexibility as to when to have meals control of blood sugar levels overnight they are helpful for people who do shift work they are helpful if travelling across different time zones Disadvantages The downsides to a basal-bolus regimen are that: people may need to take up to 4 injections a day adapting to this routine can be challenging it can be hard to remember to take the injections it can be hard to time the injections it's necessary to keep a supply of insulin w Continue reading >>

Basal-bolus Insulin In T2dm: Are Glp-1 Receptor Agonists A Better Answer?

Basal-bolus Insulin In T2dm: Are Glp-1 Receptor Agonists A Better Answer?

Eng C, Kramer CK, Zinman B, Retnakaran R. Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet 2014; 384: 2228-34 The treatment options for type 2 diabetes mellitus (T2DM) have increased dramatically over the past decade. Despite these advancements, treatment recommendations remain largely unchanged. The American Diabetes Association (ADA) recommends that patients newly diagnosed with T2DM modify their diet, exercise, and take oral medication (i.e. metformin). Only later should injectable therapies be considered. Until recently, the ADA’s treatment algorithm recommended basal-bolus insulin strategies only when three-drug oral combinations didn’t work or when the A1c was greater than 10%.1 Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are generally well tolerated, lead to significant improvements in HbA1c, stimulate glucose-dependent insulin release, and potentially preserve beta-cell mass.2,3 There are five FDA-approved GLP-1 RAs available and they are currently recommended as second-line therapy. Should GLP-1 RAs be used with basal insulin? Is this combination safer or more effective than basal-bolus insulin regimens?4,5 A recent meta-analysis examined the efficacy and safety of the GLP-1 RA plus basal insulin combination.5 Eligible studies were published between January 1, 1950 and July 29, 2014, enrolled adults with T2DM, were at least 8 weeks in duration, and provided data regarding changes in HbA1c, the proportion achieving an HbA1c less than 7.0%, or hypoglycemic events. All trials included an active comparator. Retrospective and observational studies were excluded. Lastly, results were reported consistent with the Preferred Reporting Items Continue reading >>

Understanding Basal And Bolus Insulin

Understanding Basal And Bolus Insulin

The amount of bolus insulin produced depends on the size of the meal. In a person with type 1 diabetes , the pancreas no longer automatically makes insulin regardless of the intake of glucose. The beta cells that produce the insulin have largely shut down. Both the basal, or long-term background insulin, and the bolus, or quick bursts of insulin needed at mealtimes, must be obtained through injections or an insulin pump in order to process all of the glucose taken in through food or released by the liver. Long-acting basal insulins, such as NPH, Levemir, and Lantus, begin working in 1-2 hours but are released slowly so they can last up to 24 hours, providing that background insulin that is needed around the clock . Fast-acting bolus insulins, such as NovoLog, Apidra, Humalog, and Regular, generally begin working within 15 minutes. The exception is Regular, which has an onset of about 30 minutes. Each of these bolus insulins is designed to be taken just before a meal and have a duration of up to five hours for NovoLog, Apidra, and Humalog, and seven hours for Regular. This means that a person with type 1 diabetes would have to take multiple injections of a bolus insulin each day to cover their meals and snacks, along with a basal dose to keep the background insulin in check. Basal and Bolus Insulin With Insulin Pumps The person using an insulin pump would typically receive a constant low dose of fast-acting insulin that would act as the basal background insulin. Before meals, the pump user would give a larger dose of fast-acting insulin to cover the meal about to be eaten. This satisfies both the basal and bolus needs using the same fast-acting insulin. Whether injecting with a syringe or using an insulin pump, the actual dosing and type of insulin(s) used would be dete Continue reading >>

Implementation Of Basalbolus Therapy In Type 2 Diabetes: A Randomized Controlled Trial Comparing Bolus Insulin Delivery Using An Insulin Patch With An Insulin Pen

Implementation Of Basalbolus Therapy In Type 2 Diabetes: A Randomized Controlled Trial Comparing Bolus Insulin Delivery Using An Insulin Patch With An Insulin Pen

Diabetes Technology & Therapeutics Vol. 21, No. 5 Original ArticlesOpen AccessOpen Access license Implementation of BasalBolus Therapy in Type 2 Diabetes: A Randomized Controlled Trial Comparing Bolus Insulin Delivery Using an Insulin Patch with an Insulin Pen , on behalf of the Calibra Study Group Thomas Behnke, Faramarz Beigi, Richard Bernstein, Anuj Bhargava, Hlne Bihan, Bruce Bode, Klaus Busch, Bertrand Cariou, Bogdan Catargi, Tira Chaicha-Brom, Sudesna Chatterjee, Belinda Childs, Sylvaine Clavel, Andrew Collier, Anne Farret, Leon Fogelfeld, Todd Gress, Markolf Hanefeld, Priscilla Hollander, David Huffman, Christopher Kelly, Mark Kipnes, See Kwok, Steven Leichter, Marc Lvy, Robert Lipetz, Rory McCrimmon, John McKnight, Mark Molitch, Derek Muse, Lyle Myers, Ola Odugbesan, Andreas Pftzner, Daniel Pomposini, Satyan Rajbhandari, Neda Rasouli, John Reed, Ernie Riffer, Jean-Pierre Riveline, Anthony Robinson, Peter Schwarz, Jrg Simon, William Simon, Ajay Sood, Larry Stonesifer, Charles Thivolet, Devjit Tripathy, Carl Vance, Michelle Welch, Alan Wynne, Reza Zaidi Published Online:7 May 2019 Background: Barriers to mealtime insulin include complexity, fear of injections, and lifestyle interference. This multicenter, randomized controlled trial evaluated efficacy, safety, and self-reported outcomes in adults with type 2 diabetes, inadequately controlled on basal insulin, initiating and managing mealtime insulin with a wearable patch versus an insulin pen. Methods: Adults with type 2 diabetes (n = 278, age: 59.2 8.9 years), were randomized to patch (n = 139) versus pen (n = 139) for 48 weeks, with crossover at week 44. Baseline insulin was divided 1:1 basal: bolus. Using a pattern-control logbook, subjects adjusted basal and bolus insulin weekly using fasting and premeal gluc Continue reading >>

Intensification Of Insulin Therapy For Type 2 Diabetic Patients In Primary Care: Basal-bolus Regimen Versus Premix Insulin Analogs

Intensification Of Insulin Therapy For Type 2 Diabetic Patients In Primary Care: Basal-bolus Regimen Versus Premix Insulin Analogs

In April 2012, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a joint position statement regarding treatment of hyperglycemia in type 2 diabetes, “Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach” (1). As most diabetic patients (>366 million worldwide) (2) are treated by their primary family physician and not by an endocrinologist or diabetologist, the guidelines were intended to help physicians choose the best treatment for their patients. Some of the advantages of this position statement, over previous guidelines (3–8), are as follows: emphasizing the importance of individualization of treatment, widening treatment options, and stating the pros and cons of the different treatment option. However, as the statement was written by a group of world-known diabetologists, without the input of nurses, dietitians, family physicians, or the patients themselves, questions have been raised as to how “patient-centered” it actually is and how useful and relevant it is to the primary care setting. Choosing the best insulin regimen for initiation and intensification of insulin therapy in type 2 diabetic patients is still debatable both in the specialist clinic and in the primary care setting. The intention of this article is to review the data available and offer reasonable guidance regarding the selection of the preferred insulin regimen for initiation and intensification of insulin treatment, especially in a primary care setting. The ADA/EASD statement includes recommendations for the initiation and titration of insulin therapy (1). The recommendations point out three important aspects that need to be addressed when choosing or adjusting insulin regimens: the number of injections Continue reading >>

What Is The Difference Between Basal Insulin And Bolus Insulin?

What Is The Difference Between Basal Insulin And Bolus Insulin?

Basal insulin refers to the insulin required to control your blood sugar in the absence of food intake. A certain amount of insulin is always necessary to keep the blood sugar in the normal range, even in the absence of eating for prolonged periods. Without any insulin in the body, the starch, fat, and protein in the body will break down with severe health consequences, as occurs in people with type 1 diabetes. The amount of insulin that the body requires in the absence of food intake is known as the basal requirement and it is provided by the one or two injections of long-acting insulin that most patients give themselves each day. If a person is using an insulin pump, then it is covered by the basal setting on the pump. Modern insulin pumps offer several basal settings in each 24-hour period, as the basal insulin production in a healthy individual varies over the course of the day, being higher in the 2-to 3-hour period before arising in the morning, for example. Bolus insulin refers to the insulin required to remove the energy derived from a meal from the bloodstream and into the tissues, to replenish energy stores. This is typically provided by the short-acting insulin injection given just prior to eating or by the bolus setting for patients on an insulin pump. Recently developed and marketed forms of insulin very closely match the pattern of insulin production from the pancreas itself in response to food. In this wav, they are able to prevent the blood sugar from rising excessively after a meal, while also preventing the occurrence of low blood sugar after the glucose from the meal has been cleared from the bloodstream. The latest insulin pumps offer different rates and patterns in which this bolus is given, in order to more effectively deal with rapidly or more slo Continue reading >>

The Difference Between Basal And Bolus Insulin

The Difference Between Basal And Bolus Insulin

In order to understand the role of both basal and bolus insulin, it is important to first understand how the body naturally uses glucose and insulin. When food is eaten, it is digested and converted to glucose (sugar) so it can be used for energy. Virtually every cell in the body, including your brain, needs glucose to function properly. The hormone ​insulin is needed to carry that glucose into cells in all parts of the body so that it can be used for energy. Some of this glucose is stored in the liver as a reserve fuel (called glycogen) that is released when glucose is not available through food. So, between the glucose that is consumed through food and what is gradually released from the liver, the body gets a constant supply of glucose. This also means that there needs to be a constant supply of insulin in the body to keep the amount of glucose in balance. Since more glucose is produced after a meal, the pancreas secretes more insulin. When the amount of glucose is lower, such as between meals or at night, there is less insulin needed -- but there is always at least a small amount of insulin present in the body at all times. Defining Basal and Bolus Insulin Basal insulin is the background insulin that is normally supplied by the pancreas and is present 24 hours a day, whether or not the person eats. Bolus insulin refers to the extra amounts of insulin the pancreas would naturally make in response to glucose taken in through food. The amount of bolus insulin produced depends on the size of the meal. In a person with type 1 diabetes, the pancreas no longer automatically makes insulin regardless of the intake of glucose. The beta cells that produce the insulin have largely shut down. Both the basal, or long-term background insulin, and the bolus, or quick bursts of in Continue reading >>

What Is Basal-bolus Insulin Therapy For Diabetes?

What Is Basal-bolus Insulin Therapy For Diabetes?

“Basal-bolus” insulin therapy is a form of insulin treatment that is designed to mimic the natural pattern of insulin release seen in someone who is not diabetic. It is the “gold standard” of insulin treatment and it is the right approach to treating most people with type 1 diabetes and some people with type 2. Let’s start by remembering that we need glucose in our bloodstream at all times. It serves as the source of energy for all the cells in our body. But in order to use the glucose as fuel, most cells require insulin as well. The glucose ultimately all comes from our food, but the pattern of glucose fluctuation that we see over a day results from periods of eating and fasting. When we eat, our blood sugar levels rise and the body makes more insulin to compensate for this. A large amount of glucose absorbed into the body quickly is a called a “bolus,” and the rise and fall of insulin that accompanies our meals is called “bolus” insulin. When the body is not capable of making that insulin, we inject short-acting or “bolus” insulin to do the job. Short-acting or bolus insulins are so-called “regular” insulin or the brand name insulins NovoLog, Humalog and Apidra. There is also an inhaled form of bolus insulin called Afrezza which came to market in 2015. The amount of bolus insulin administered depends on the amount of carbohydrate we eat, just as the body would make more or less for larger or smaller meals. A few hours after a meal, the glucose from that meal has either been used for fuel or stored for later use. At that stage, the liver and muscles begin to release the stored glucose in a “basal” fashion, meaning “baseline” or “background.” The muscles mostly use the glucose they release inside their own cells, but the liver relea Continue reading >>

Evidence For Basal–bolus Insulin Versus Slide Scale Insulin

Evidence For Basal–bolus Insulin Versus Slide Scale Insulin

Abstract Greater understanding of hyperglycemia and its control in non-ICU patients has become ever more urgent given the high and increasing prevalence of diabetes in the general population and, hence, in hospitalized patients. It is well accepted that hyperglycemia in hospitalized patients is common and associated with profound medical consequences, longer lengths of stay, high healthcare costs, and adverse outcomes. It is a marker for poor clinical outcome and mortality. Although evidence that supports intensive glycemic control in critically ill patients is strong, glycemic control is often overlooked or insufficient in patients on general medicine and surgery services. In the face of strong evidence that glycemic control helps to improve outcomes in non-ICU patients, it is critical to consider how best to manage hyperglycemia in medical and surgical patients to develop optimum strategies for maintaining glycemic control. Currently available strategies for glycemic control include sliding-scale insulin and basal–bolus regimens. The principal difference between the two strategies is that sliding-scale insulin does not deliver adequate glycemic control to patients and addresses hyperglycemia after it has occurred, whereas a basal–bolus regimen is directed at preventing hyperglycemia. This paper explores the rationale for and implementation of a basal–bolus insulin regimen in non-critically ill hospitalized patients and in addition reviews best practices for transitions of care and discharge planning. Discover the world's research 14+ million members 100+ million publications 700k+ research projects Join for free Continue reading >>

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