临床时讯 ＞ 临床研究
Nutr Clin Pract. 2009 Dec;24(6):718-22.
Evaluation of glycemic control using NPH insulin sliding scale versus insulin aspart sliding scale in continuously tube-fed patients.
Cook A, Burkitt D, McDonald L, Sublett L.
St. Vincent Indianapolis Hospital, Indianapolis, Indiana, USA.
BACKGROUND: Hyperglycemia is often a problem in patients who receive continuous enteral nutrition. The purpose of this study was to determine if the use of sliding-scale neutral protamine Hagedorn (NPH) insulin was more effective than sliding-scale insulin aspart in controlling blood glucose in continuously tube-fed patients. METHODS: A retrospective, records-based review comparing sliding-scale NPH insulin given every 4 or 6 hours with sliding-scale insulin aspart was performed in patients admitted to 2 community hospitals between April 1, 2006, and September 30, 2007. RESULTS: Mean blood glucose was found to be lower in patients receiving NPH every 4 hours and NPH every 6 hours than in patients receiving insulin aspart (P < .001). No statistically significant differences in mean blood glucose values (P = .41) were observed between patients receiving the NPH regimen given every 4 or 6 hours. More patients in the NPH groups had blood glucose values in the target and acceptable ranges than those in the insulin aspart group (P < .001), but no statistical significance was observed between the groups receiving NPH every 4 hours and NPH every 6 hours (P = .41). CONCLUSIONS: In this study, sliding-scale NPH insulin was demonstrated to be a safe and effective management strategy for blood glucose control in continuously tube-fed patients; NPH insulin resulted in better blood glucose control compared with insulin aspart.