Insulin Schemes for Type 2 Diabetes Control
Type 2 Diabetes Mellitus
About this trial
This is an interventional treatment trial for Type 2 Diabetes Mellitus
Eligibility Criteria
Inclusion Criteria:
- Patients between 18 and 100 years old.
- History of type 2 diabetes mellitus (DM2) or that upon admission is diagnosed by values of glycated haemoglobin (HbA1) > 6.5%
- Fasting central glucose before randomization between 140mg/dl and 400mg/dl
- Non-critical patients hospitalized in the service of Internal Medicine (MI), General Surgery (CG) and Traumatology (TyO).
- Patients receiving a diabetic diet orally
- Treated with diet alone, o any combination of oral anti-diabetic agents or insulin treatment with any dosage before admission.
Exclusion Criteria:
- Parenteral nutrition
- Hyperglycemia without a known history of diabetes
- Impaired renal function (glomerular filtration rate less than 30)
- Diabetic ketoacidosis and hyperosmolar state
- Type 1 Diabetes mellitus
- Pregnancy
- Patients on treatment with more than 10mg prednisone or steroid boluses.
- Known hypopituitarism or adrenal insufficiency
- Hyperglycaemia due to stress (negative antecedent of DM2, hyperglycemia and HbA1 <6.5)
- Severe liver disease (Child-Pugh C score)
- Acute pancreatitis
- Patients with sepsis or multiple organ failure
- Candidates for intensive care unit
Sites / Locations
- Hospital General de León
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
NPH insulin group
Glargine and Lispro insulin group
Patients receiving NPH twice daily, 2/3 in the morning and 1/3 in the night. A correctional dose of lispro insulin will be given for any blood glucose >180 mg/dL. If subjects were not eating, they shouldn't receive dose of NPH insulin. Intervention Drug: NPH insulin
Half of the total of Glargine and Lispro insulin dose will be given as glargine once daily, either in the morning or in the evening, depending on when the patient was enrolled. The other half of the total daily insulin dose will be given as Lispro; doses were divided equally for breakfast, lunch, and dinner. An additional correctional dose of Lispro will be given for any blood glucose >180 mg/dL. If subjects were not eating, they received glargine once daily and they shouldn't receive doses of lispro. Intervention drug: Glargine and Lispro