Benefits of Insulin Supplementation for Correction of Hyperglycemia in Patients With Type 2 Diabetes
Benefits of Insulin Supplementation for Correction of Hyperglycemia in Patients With Type 2 Diabetes
The purpose of this study is to test whether using extra doses of aspart insulin to correct
 blood sugars before meals improves the care of patients with type 2 diabetes in the hospital
 who are already receiving the standard of care treatment with glargine and aspart insulin
 injections to control blood sugar levels. Studies done in the past indicate that blood sugar
 levels are controlled on the standard treatment of insulin and that most patients do not need
 the small extra dose of insulin at bedtime. The investigators want to test if there is any
 benefit to giving patients extra doses of insulin during the day to correct the high blood
 sugars.
The management of patients with Type 2 diabetes involves treatment with two different types
 of insulin injections to control blood sugar levels. The doses of the two types of insulins,
 glargine insulin and aspart insulin are adjusted daily through the hospital stay based on
 blood sugar levels. Many times, in addition to glargine and aspart insulin at meals,
 additional small doses of aspart insulin are given to correct high blood sugar levels. It has
 not been determined if using these extra doses of aspart insulin to correct blood sugars
 before meals improves care of the patients. Studies done in the past indicate that blood
 sugar levels are well controlled on the standard treatment of the two insulins and that most
 patients do not need the small extra dose of insulin at bedtime. This study will test if
 insulin supplementation improves glycemic control and prevents hypoglycemia in insulin
 treated patients with type 2 diabetes mellitus.
Inclusion Criteria:

 1. Subjects admitted to the hospital with acute or chronic medical illnesses or for
 elective and emergency surgical illness or trauma

 2. Known history of Type 2 diabetes mellitus for >3 months

 3. Treated with either diet alone, any combination of oral antidiabetic agents,
 non-insulin injectables or insulin therapy

 4. Blood glucose levels between >140 mg and <400 mg/dL without laboratory evidence of
 diabetic ketoacidosis

 Exclusion Criteria:

 1. Hyperglycemia without a history of diabetes

 2. Subjects with acute critical illness admitted to the ICU or expected to require ICU
 admission

 3. Subjects receiving continuous insulin infusion

 4. Clinically relevant hepatic disease

 5. Corticosteroid therapy

 6. Serum creatinine ≥ 3.5 mg/dL and/or glomerular filtration rate (GFR) <30

 7. Subjects unable to sign consent

 8. Pregnancy