Transition from intravenous to subcutaneous insulin: Effectiveness and safety of a standardized protocol and predictors of outcome in patients with acute coronary syndrome

Fausto Avanzini, Giuseppe Marelli, Walter Donzelli, Giovanna Busi, Stefania Carbone, Laura Bellato, Elena Lucia Colombo, Roberto Foschi, Emma Riva, Maria Carla Roncaglioni, Mario De Martini

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

OBJECTIVE - The study objectives were 1) to assess the effectiveness and safety of a standardized protocol for the transition to subcutaneous insulin and oral feeding in diabetic or hyperglycemic patients with acute coronary syndrome (ACS) who were receiving intravenous insulin and glucose at the time of the transfer from the intensive cardiac care unit to a general ward and 2) to identify predictors of transition outcome. RESEARCH DESIGN AND METHODS - This was a prospective observational study. The protocol specifies that patients receive a 100% of their daily subcutaneous insulin requirement from the first day of oral feeding, calculated from the intravenous insulin rate during the final 12 h divided into two: 50% basal and 50% prandial. RESULTS - In 142 patients (93 male, 49 female, age range 47-88 years, 135 with known diabetes) the first day after transition, 44.8% of blood glucose (BG) measurements were within the strict range of 100-140 mg/dL before meals and 100-180 mg/dL after meals, and 70.8% were within the broader ranges of 80-160 mg/dL and 80-200 mg/dL, respectively. Pre- or postprandial hypoglycemia (BG

Original languageEnglish
Pages (from-to)1445-1450
Number of pages6
JournalDiabetes Care
Volume34
Issue number7
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Acute Coronary Syndrome
Insulin
Meals
Safety
Blood Glucose
Patients' Rooms
Parenteral Nutrition
Hypoglycemia
Observational Studies
Intensive Care Units
Research Design
Prospective Studies
Glucose

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Transition from intravenous to subcutaneous insulin : Effectiveness and safety of a standardized protocol and predictors of outcome in patients with acute coronary syndrome. / Avanzini, Fausto; Marelli, Giuseppe; Donzelli, Walter; Busi, Giovanna; Carbone, Stefania; Bellato, Laura; Colombo, Elena Lucia; Foschi, Roberto; Riva, Emma; Roncaglioni, Maria Carla; De Martini, Mario.

In: Diabetes Care, Vol. 34, No. 7, 07.2011, p. 1445-1450.

Research output: Contribution to journalArticle

Avanzini, F, Marelli, G, Donzelli, W, Busi, G, Carbone, S, Bellato, L, Colombo, EL, Foschi, R, Riva, E, Roncaglioni, MC & De Martini, M 2011, 'Transition from intravenous to subcutaneous insulin: Effectiveness and safety of a standardized protocol and predictors of outcome in patients with acute coronary syndrome', Diabetes Care, vol. 34, no. 7, pp. 1445-1450. https://doi.org/10.2337/dc10-2023
Avanzini, Fausto ; Marelli, Giuseppe ; Donzelli, Walter ; Busi, Giovanna ; Carbone, Stefania ; Bellato, Laura ; Colombo, Elena Lucia ; Foschi, Roberto ; Riva, Emma ; Roncaglioni, Maria Carla ; De Martini, Mario. / Transition from intravenous to subcutaneous insulin : Effectiveness and safety of a standardized protocol and predictors of outcome in patients with acute coronary syndrome. In: Diabetes Care. 2011 ; Vol. 34, No. 7. pp. 1445-1450.
@article{d9eb56d7f68b47a586b0b1c3dba3c9d5,
title = "Transition from intravenous to subcutaneous insulin: Effectiveness and safety of a standardized protocol and predictors of outcome in patients with acute coronary syndrome",
abstract = "OBJECTIVE - The study objectives were 1) to assess the effectiveness and safety of a standardized protocol for the transition to subcutaneous insulin and oral feeding in diabetic or hyperglycemic patients with acute coronary syndrome (ACS) who were receiving intravenous insulin and glucose at the time of the transfer from the intensive cardiac care unit to a general ward and 2) to identify predictors of transition outcome. RESEARCH DESIGN AND METHODS - This was a prospective observational study. The protocol specifies that patients receive a 100{\%} of their daily subcutaneous insulin requirement from the first day of oral feeding, calculated from the intravenous insulin rate during the final 12 h divided into two: 50{\%} basal and 50{\%} prandial. RESULTS - In 142 patients (93 male, 49 female, age range 47-88 years, 135 with known diabetes) the first day after transition, 44.8{\%} of blood glucose (BG) measurements were within the strict range of 100-140 mg/dL before meals and 100-180 mg/dL after meals, and 70.8{\%} were within the broader ranges of 80-160 mg/dL and 80-200 mg/dL, respectively. Pre- or postprandial hypoglycemia (BG",
author = "Fausto Avanzini and Giuseppe Marelli and Walter Donzelli and Giovanna Busi and Stefania Carbone and Laura Bellato and Colombo, {Elena Lucia} and Roberto Foschi and Emma Riva and Roncaglioni, {Maria Carla} and {De Martini}, Mario",
year = "2011",
month = "7",
doi = "10.2337/dc10-2023",
language = "English",
volume = "34",
pages = "1445--1450",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "7",

}

TY - JOUR

T1 - Transition from intravenous to subcutaneous insulin

T2 - Effectiveness and safety of a standardized protocol and predictors of outcome in patients with acute coronary syndrome

AU - Avanzini, Fausto

AU - Marelli, Giuseppe

AU - Donzelli, Walter

AU - Busi, Giovanna

AU - Carbone, Stefania

AU - Bellato, Laura

AU - Colombo, Elena Lucia

AU - Foschi, Roberto

AU - Riva, Emma

AU - Roncaglioni, Maria Carla

AU - De Martini, Mario

PY - 2011/7

Y1 - 2011/7

N2 - OBJECTIVE - The study objectives were 1) to assess the effectiveness and safety of a standardized protocol for the transition to subcutaneous insulin and oral feeding in diabetic or hyperglycemic patients with acute coronary syndrome (ACS) who were receiving intravenous insulin and glucose at the time of the transfer from the intensive cardiac care unit to a general ward and 2) to identify predictors of transition outcome. RESEARCH DESIGN AND METHODS - This was a prospective observational study. The protocol specifies that patients receive a 100% of their daily subcutaneous insulin requirement from the first day of oral feeding, calculated from the intravenous insulin rate during the final 12 h divided into two: 50% basal and 50% prandial. RESULTS - In 142 patients (93 male, 49 female, age range 47-88 years, 135 with known diabetes) the first day after transition, 44.8% of blood glucose (BG) measurements were within the strict range of 100-140 mg/dL before meals and 100-180 mg/dL after meals, and 70.8% were within the broader ranges of 80-160 mg/dL and 80-200 mg/dL, respectively. Pre- or postprandial hypoglycemia (BG

AB - OBJECTIVE - The study objectives were 1) to assess the effectiveness and safety of a standardized protocol for the transition to subcutaneous insulin and oral feeding in diabetic or hyperglycemic patients with acute coronary syndrome (ACS) who were receiving intravenous insulin and glucose at the time of the transfer from the intensive cardiac care unit to a general ward and 2) to identify predictors of transition outcome. RESEARCH DESIGN AND METHODS - This was a prospective observational study. The protocol specifies that patients receive a 100% of their daily subcutaneous insulin requirement from the first day of oral feeding, calculated from the intravenous insulin rate during the final 12 h divided into two: 50% basal and 50% prandial. RESULTS - In 142 patients (93 male, 49 female, age range 47-88 years, 135 with known diabetes) the first day after transition, 44.8% of blood glucose (BG) measurements were within the strict range of 100-140 mg/dL before meals and 100-180 mg/dL after meals, and 70.8% were within the broader ranges of 80-160 mg/dL and 80-200 mg/dL, respectively. Pre- or postprandial hypoglycemia (BG

UR - http://www.scopus.com/inward/record.url?scp=80054698640&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054698640&partnerID=8YFLogxK

U2 - 10.2337/dc10-2023

DO - 10.2337/dc10-2023

M3 - Article

C2 - 21593302

AN - SCOPUS:80054698640

VL - 34

SP - 1445

EP - 1450

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 7

ER -