Subcutaneous administration of glargine to diabetic patients receiving insulin infusion prevents rebound hyperglycemia
Abstract
Context Transition of diabetic patients from iv insulin infusion to s.c. insulin frequently results in rebound hyperglycemia. Objectives We hypothesized that initiation of a long-acting insulin therapy concurrently with i.v. insulin infusion would decrease the rate of rebound hyperglycemia after discontinuation of the insulin infusion. Design and intervention Sixty-one diabetic patients receiving i.v. insulin therapy participated in this prospective randomized study. Subjects in the intervention group received daily injections of glargine s.c. (0.25 U/kg body weight) starting within 12 h of initiation of i.v. insulin infusion. Capillary blood glucose measurements were obtained up to 12 h after discontinuation of insulin infusion. Rebound hyperglycemia was defined as a blood glucose level greater than 180 mg/dl. Setting The study was conducted at the University of Colorado Hospital. Patients Sixty-one hospitalized patients with known type 1 or type 2 diabetes receiving i.v. insulin infusion participated in the study. Main outcome The primary outcome of this study was to compare the rates of rebound hyperglycemia between the control and the intervention groups after i.v. insulin infusion is discontinued. Results Overall, 29 subjects in the control group (93.5%) had at least one glucose value above 180 mg/dl during the 12-h follow-up period. This was significantly greater than the rate of rebound hyperglycemia in the intervention group (10 subjects or 33.3%, P Conclusions Once-d…
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Emerging data from studies in people with hyperglycemia with and without diabetic ketoacidosis (DKA) show that the administration of a low dose (0.15-0.3 units/kg) of basal insulin analog in addition to intravenous insulin infusion may reduce the duration of insulin infusion and length of hospital stay and prevent rebound hyperglycemia without increased risk of hypoglycemia.
“Emerging data from studies in people with hyperglycemia with and without diabetic ketoacidosis (DKA) show that the administration of a low dose (0.15-0.3 units/kg) of basal insulin analog in addition to intravenous insulin infusion may reduce the duration of insulin infusion and length of hospital stay and prevent rebound hyperglycemia without increased risk of hypoglycemia (64)(65)(66)(67).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [65]
Administration of a low dose of basal insulin analog in addition to intravenous insulin infusion early in treatment may prevent rebound hyperglycemia without increased risk of hypoglycemia.
“Studies have reported that the administration of a low dose of basal insulin analog in addition to intravenous insulin infusion early in the course of treatment may prevent rebound hyperglycemia without increased risk of hypoglycemia (64-66,179).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [65]
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- Authors
- Hsia, E., Seggelke, S., Gibbs, J., Hawkins, R. M., Cohlmia, E., Rasouli, N., Wang, C., Kam, I., & Draznin, B.
- Affiliations
- Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045
- Denver VA Medical Center (US)
- Department of Medicine, Division of Transplant Surgery, and Department of Surgery (I.K.), Denver, Colorado 80045
- Corresponding author
- Draznin, Boris
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-09-01
- Volume
- 97
- Issue
- 9
- Pages
- 3132-3137
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2154749408
- Cited by
- 112
- References
- 4
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 13 · 2023: 8 · 2022: 10 · 2021: 7 · 2020: 8 · 2019: 7 · 2018: 6 · 2017: 9 · 2016: 10 · 2015: 9 · 2014: 3 · 2013: 6 · 2012: 1
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- glargine, subcutaneous insulin, insulin infusion, rebound hyperglycemia, type 1 diabetes, type 2 diabetes, insulin discontinuation, long-acting insulin, hypoglycemia, diabetic ketoacidosis, organ transplantation, surgical patients
- MeSH terms
- Insulin Glargine, Adult, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Hyperglycemia, Hypoglycemic Agents, Injections, Subcutaneous, Insulin Infusion Systems, Male, Middle Aged, Prospective Studies, Treatment Outcome, Insulin, Long-Acting
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