Background Hyperglycaemia is very frequent in hospitalised patients, increasing the risk of complications, disability and death. An adequate control through the use of insulin is especially important in reducing these. The most recommended administration regimen consists of a basal insulin, a prandial insulin and a scheme correction should replace the monotherapy of insulin with a scheme of correction, since this is ineffective and even entails some risks.
Purpose To analyse the suitability of prescribing insulin guidelines in patients admitted to a third-level hospital based on the recommendations of the Local Society of Endocrinology, Diabetes and Nutrition.
Material and methods Descriptive observational cross-sectional study. All non-critical patients diagnosed with diabetes mellitus who started treatment with insulin (slow action) for 15 days were included. Variables collected: age, sex, basal insulin dose, bolus dose, bolus correction dose and whether or not they had an oral diet in order to evaluate the adequacy of treatment. The prescriptions that followed the Local Society recommendations were considered correct: dose of insulin if oral diet: 50% basal +50% prandial bolus (30% breakfast, 40% lunch and 30% dinner)±correction dose; if not oral diet: 50% basal ±correction regime.
Results Sixty patients were included (average age: 74.68 years (42–90); 56.66% males (n=34) and 43.33% females (n=26). Insulin prescription was: 98.33% (n=59) insulin glargine and 1.66% (n=1) insulin degludec. Fifty-seven (955) patients had an oral diet. Of these, eight (14.03%) were considered correct prescriptions. Among the considered incorrect prescriptions (85.96%), the errors were: 57.14% did not have a bolus prescription, 30.61% did not adjust the 50% basal dose +50% bolus dose and 12.24% had negative correction higher than the prescribed. No dietary data were obtained from three patients and, therefore, the study was not followed in them.
Conclusion According to the results obtained and, although the study has limitations such as the lack of registration of glycemia and the possibility that some patients do not need bolus doses for blood glucose control, it is clear that there is much to improve. This work opens the way to continue deepening the subject and making appropriate interventions.
References and/or acknowledgements Colleges.
No conflict of interest.
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