Scientific Poster Session III - Original Research

Original Research
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Introduction: Insulin therapy is the foundation of inpatient management of diabetes mellitus regardless of usage in patients’ home regimens. Basal insulin combined with mealtime insulin is a standard approach appropriate for most hospitalized patients. Although some patients may already be using a certain basal insulin product at home, the conversion to another product may be necessary once admitted to the hospital depending on formulary availability. Protocols between institutions and clinical settings lack standardization and there is currently minimal evidence suggesting the effectiveness and safety of standard conversion ratios between long-acting insulin products. This retrospective chart review aimed to investigate the dose conversion ratio of non-formulary insulin degludec to insulin glargine for inpatient diabetes management.

Research Question or Hypothesis: What is the effectiveness and safety of converting insulin degludec to insulin glargine in a 1:1 ration versus 1:1.2 ratio?

Study Design: A multicenter, non-interventional, retrospective cohort chart review was conducted over 3 years at UNC Health institutions in North Carolina, United States.

Methods: 1,037 patients were included to compare the incidence of hyperglycemic episodes when converting from insulin degludec to insulin glargine at a standard 1:1 ratio versus an alternative 1:1.2 ratio.

Results: Primary endpoint analysis showed that utilizing the alternative conversion ratio was associated with fewer patients with five or more episodes of non-severe hyperglycemia (blood glucose >180 mg/dL; p<0.0146). The alternative conversion ratio was also found to be associated with fewer episodes of severe hyperglycemia (blood glucose >200 mg/dL; p<0.0005), although it was not significantly associated with fewer patients with less than five episodes of hyperglycemia or hypoglycemia (blood glucose <70 mg/dL).

Conclusion: This observational study suggests the effectiveness of an alternative basal insulin conversion ratio with fewer hospitalized patients experiencing multiple episodes of hyperglycemia and no difference in the incidence of hypoglycemia despite more units of insulin administered.

Presenting Author

Sitong Shu PharmD
15

Authors

Dr. Tramaine Young PharmD, MSCR
15