Impact of Insulin Detemir Administration Time on Hypoglycemia Rates in Hospitalized Patients.
Pharmacotherapy. 2017 Oct 13;:
Authors: Grelle JL, Kutter SN, Giruzzi ME, Tawwater JC
STUDY OBJECTIVE: To determine if insulin detemir administration time affects the frequency of hypoglycemia (blood glucose level <70 mg/dL) in hospitalized patients.
DESIGN: Retrospective cohort study.
PATIENTS: A total of 357 adults (aged 18-89 yrs) who received insulin detemir for at least 48 hours while hospitalized between January 1, 2014, and December 31, 2015, were included. Patients were categorized into one of three groups according to insulin detemir administration time: detemir given once daily between 7 A.M. and 10 A.M. (AM group [71 patients]), detemir given once daily between 6 P.M. and 10 P.M. (PM group [158 patients]), and detemir given twice daily (BID group [128 patients]).
SETTING: Community hospital.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was the percentage of patient days with any occurrence of hypoglycemia. The key secondary outcomes included the percentages of patients who experienced any hypoglycemic event, severe hypoglycemia, hypoglycemia requiring treatment, and refractory hypoglycemia; time of hypoglycemia; and percentage of patients experiencing one or more episodes of hyperglycemia. The AM group had a lower proportion of days with hypoglycemia compared with the PM group (7.9% vs. 11.9%, p=0.008). There was a nonsignificant trend toward a lower proportion of days with hypoglycemia in the BID group compared with the PM group (9.1% vs. 11.9%, p=0.0302). No significant differences in percentage of patient days with hyperglycemia and rates of severe hypoglycemia, hypoglycemia requiring treatment, or refractory hypoglycemia were noted among the three groups.
CONCLUSION: Administration of detemir in the morning may reduce the occurrence of hypoglycemia in hospitalized patients. Institutions that include detemir on their formularies may consider evaluating the incidence of hypoglycemia and modifying administration schedules as part of their medication safety program. This article is protected by copyright. All rights reserved.
PMID: 29028123 [PubMed - as supplied by publisher]