Subcutaneous Administration of Glargine to Diabetic Patients Receiving Insulin Infusion Prevents Rebound Hyperglycemia

Context: Transition of diabetic patients from iv insulin infusion to sc insulin frequently results in rebound hyperglycemia. Objectives: We hypothesized that initiation of a long-acting insulin therapy concurrently with iv insulin infusion would decrease the rate of rebound hyperglycemia after discontinuation of the insulin infusion. Design and Intervention: Sixty-one diabetic patients receiving iv insulin therapy participated in this prospective randomized study. Subjects in the intervention group received daily injections of glargine sc (0.25 U/kg body weight) starting within 12 h of initiation of iv 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 iv insulin infusion participated in the st...