Don’t use the ‘sliding scale insulin therapy’ for the treatment of hyperglycemia in hospitalized patients.
The practice of insulin therapy by sliding scale, that is, injecting insulin at set intervals (every 4-6 hours) only if the glycemia goes above a fixed threshold is still common in our country too, but it should be considered an inadequate and ineffective method. This approach, in fact, as well as not facing the problem of basic insulinization, does not prevent hyperglycemia either ,intervening only after it has been found and represents a risk of subsequent hypoglycemia. The insulin therapy on a sliding scale basis leads to therapeutic inertia and also the risks represented by a lack of therapeutic planning.
1. Umpierrez GE, Smiley D, Jacobs S, et al. M. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care. 2011; 34: 256-61.
2. Umpierrez GE, Smiley D, Zisman A, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes (RABBIT 2 trial). Diabetes Care. 2007; 30: 2181-6.
3. AMD-SID. Standard italiani per la cura del diabete mellito 2014. www.standarditaliani.it
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.