A Deficit in Care: Comparing Insulin Therapy Treatments in Hospitalized Patients with Diabetes Mellitus

Abstract

In 2015, 7.2% of the U.S. population had been diagnosed with diabetes mellitus (Centers for Disease Control, 2017). Diabetes mellitus can be classified as type one or type two. Type one diabetes is an autoimmune disease and type two diabetes is a chronic metabolic disorder. There has been an increase in the number of insulin dependent diabetics of both types seen in hospital settings. Person with diabetes have individualized insulin therapy treatments adjusted specifically to their daily needs. Hyperglycemia, which is a high amount of glucose (sugar) within the blood stream that can be measured by taking a blood glucose level, is a common side effect of diabetes that is often seen in the hospital setting. Hyperglycemia damages blood vessels leading to many health problems including blindness, kidney and liver failure, and neuropathy (Hoffman & Sullivan, 2017). To treat hyperglycemia, hospitals have established a basic treatment protocol called Sliding Scale Insulin Therapy, which predetermines the amount of insulin given to a patient according to their blood glucose level. The alternative treatment in this study would be Basal Bolus therapy, which controls blood sugar levels through a combination of long-acting or basal insulin and fast-acting or bolus insulin. The purpose of this Evidence Based Practice Brief is to compare Sliding Scale Insulin Therapy to its counterpart Basal Bolus Insulin Therapy to provide evidence on which protocol could support patient’s overall health.