RT Journal Article
T1 Regular insulin added to total parenteral nutrition vs subcutaneous glargine in non-critically ill diabetic inpatients, a multicenter randomized clinical trial: INSUPAR trial.
A1 Olveira, Gabriel
A1 Abuín, Jose
A1 López, Rafael
A1 Herranz, Sandra
A1 García-Almeida, Jose M
A1 García-Malpartida, Katherine
A1 Ferrer, Mercedes
A1 Cancer, Emilia
A1 Luengo-Pérez, Luis M
A1 Álvarez, Julia
A1 Aragón, Carmen
A1 Ocón, María J
A1 García-Manzanares, Álvaro
A1 Bretón, Irene
A1 Serrano-Aguayo, Pilar
A1 Pérez-Ferre, Natalia
A1 López-Gómez, Juan J
A1 Olivares, Josefina
A1 Arraiza, Carmen
A1 Tejera, Cristina
A1 Martín, Jorge D
A1 García, Sara
A1 Abad, Ángel L
A1 Alhambra, María R
A1 Zugasti, Ana
A1 Parra, Juan
A1 Torrejón, Sara
A1 Tapia, María J
K1 Diabetes
K1 Glargine insulin
K1 Insulin regimen
K1 Non-critically ill patient
K1 TPN
AB There is no established insulin regimen in T2DM patients receiving parenteral nutrition. To compare the effectiveness (metabolic control) and safety of two insulin regimens in patients with diabetes receiving TPN. Prospective, open-label, multicenter, clinical trial on adult inpatients with type 2 diabetes on a non-critical setting with indication for TPN. Patients were randomized on one of these two regimens: 100% of RI on TPN or 50% of Regular insulin added to TPN bag and 50% subcutaneous GI. Data were analyzed according to intention-to-treat principle. 81 patients were on RI and 80 on GI. No differences were observed in neither average total daily dose of insulin, programmed or correction, nor in capillary mean blood glucose during TPN infusion (165.3 ± 35.4 in RI vs 172.5 ± 43.6 mg/dL in GI; p = 0.25). Mean capillary glucose was significantly lower in the GI group within two days after TPN interruption (160.3 ± 45.1 in RI vs 141.7 ± 43.8 mg/dL in GI; p = 0.024). The percentage of capillary glucose above 180 mg/dL was similar in both groups. The rate of capillary glucose ≤70 mg/dL, the number of hypoglycemic episodes per 100 days of TPN, and the percentage of patients with non-severe hypoglycemia were significantly higher on GI group. No severe hypoglycemia was detected. No differences were observed in length of stay, infectious complications, or hospital mortality. Effectiveness of both regimens was similar. GI group achieved better metabolic control after TPN interruption but non-severe hypoglycemia rate was higher in the GI group. This trial is registered at clinicaltrials.gov as NCT02706119.
YR 2019
FD 2019-03-20
LK http://hdl.handle.net/10668/13775
UL http://hdl.handle.net/10668/13775
LA en
DS RISalud
RD Apr 7, 2025