Eliminating Inpatient Sliding-Scale Insulin: A Reeducation Project With Medical House Staff
Response to Baldwin et al.
- Ali A. Rizvi, MD
- From the Division of Endocrinology, Diabetes, and Metabolism, University of South Carolina School of Medicine, Columbia, South Carolina
- Address correspondence to Dr. Ali A. Rizvi, University of South Carolina School of Medicine, Division of Endocrinology, Diabetes, and Metabolism, 2 Medical Park, Suite 502, Columbia, SC 29203-6840. E-mail: arizvi{at}gw.mp.sc.edu
The study by Baldwin et al. (1) had the laudable intention of training house staff in moving away from inpatient sliding-scale insulin in favor of a basal-bolus approach or active titration of oral agents. However, some key points in their report remain unexplained. The authors state that in insulin-treated patients, the premeal short-acting insulin (usually regular) in combination with a basal insulin (usually NPH) was used. However, no details are given as to how the NPH was titrated and what parameters, if any, were used for adjustment. Even more notable …
