Updating beers criteria
Rapid-acting insulin is used to cover nutritional intake and correct hyperglycemia. Basal plus rapid-acting insulin (often called basal/bolus insulin therapy) most closely mimics normal physiologic insulin production and controls blood glucose more effectively. Glycaemic variability and complications in patients with diabetes mellitus: evidence from a systematic review of the literature.
The use of long-acting basal insulin has been shown to provide glycemic control superior to sliding-scale insulin with less hypoglycemic risk.11 Nutritional or bolus insulin is recommended to cover insulin needs to convert mealtime glucose into energy without postprandial hyperglycemia. Within a few hours, his or her glucose level increases, leaving him or her with long periods of high blood glucose levels.Insulin is then administered with the next glucose check, and blood glucose returns to normal.This “roller coaster” effect of fluctuating glucose levels repeats itself with evidence existing now that these fluctuations are more harmful physiologically than blood glucose levels that are continuously elevated, even when the elevation is considered mild.10 Pushing for Structured Insulin Regimens Best practice guidelines now recommend the use of structured insulin regimens with three components: basal insulin, nutritional insulin, and correctional insulin.Regimens combining these components have been shown to reduce fluctuations in blood glucose levels, increase the number of days patients maintain acceptable blood glucose levels, and reduce the length of non-ICU stays for hospitalized patients.