Transitioning safely from intravenous to subcutaneous insulin

Current Diabetes Reports
Kathryn Evans Kreider, Lillian F Lien

Abstract

The transition from intravenous (IV) to subcutaneous (SQ) insulin in the hospitalized patient with diabetes or hyperglycemia is a key step in patient care. This review article suggests a stepwise approach to the transition in order to promote safety and euglycemia. Important components of the transition include evaluating the patient and clinical situation for appropriateness, recognizing factors that influence a safe transition, calculation of proper SQ insulin doses, and deciding the appropriate type of SQ insulin. This article addresses other clinical situations including the management of patients previously on insulin pumps and recommendations for patients requiring glucocorticoids and enteral tube feedings. The use of institutional and computerized protocols is discussed. Further research is needed regarding the transition management of subgroups of patients such as those with type 1 diabetes and end-stage renal disease.

References

Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
Oct 4, 2002·The American Journal of Medicine·Lee N MetchickUNKNOWN Section of Endocrinology, Department of Medicine, Yale Universtiy School of Medicine, New Haven, Connecticut
May 29, 2003·The Journal of Thoracic and Cardiovascular Surgery·Anthony P FurnaryAlbert Starr
Oct 28, 2003·Diabetes Care·Matthew C RiddleUNKNOWN Insulin Glargine 4002 Study Investigators
Jan 30, 2004·Diabetes Care·Stephen ClementUNKNOWN American Diabetes Association Diabetes in Hospitals Writing Committee
Jul 15, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Bruce W BodePaul C Davidson
Aug 17, 2004·The Medical Clinics of North America·Lillian F LienMark N Feinglos
Sep 18, 2004·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Linda A Browning, Peter Dumo
Oct 6, 2004·Current Diabetes Reports·Andrew J Ahmann
Jul 12, 2005·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Lillian F LienMark N Feinglos
Aug 9, 2006·The American Journal of Cardiology·Anthony P Furnary, Susan S Braithwaite
Nov 3, 2006·The New England Journal of Medicine·Silvio E Inzucchi
Jan 11, 2007·Diabetes Care·Mark WilsonGuy W Soo Hoo
Jan 19, 2007·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Lowell R SchmeltzMark E Molitch
Mar 31, 2007·Seminars in Thoracic and Cardiovascular Surgery·Susan S Braithwaite
May 11, 2007·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Lama H NazerEtie S Moghissi
Jun 30, 2007·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Swati DattaDavid Baldwin
Jul 3, 2007·The American Journal of Medicine·Guillermo E UmpierrezDawn Smiley
Oct 28, 2008·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Cheryl W O'MalleyUNKNOWN Society of Hospital Medicine Glycemic Control Task Force
Feb 13, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Rachel M BailonCurtiss B Cook
Apr 2, 2009·The Annals of Pharmacotherapy·Kyle A Weant, Alim Ladha
May 21, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Etie S MoghissiUNKNOWN American Diabetes Association
Jun 6, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Michelle L NoscheseMary T Korytkowski
Jul 1, 2009·Diabetes Care·Abbas E KitabchiJoseph N Fisher
Nov 4, 2009·Journal of Diabetes Science and Technology·Brenda J LeonhardiCurtiss B Cook
Dec 31, 2009·Current Opinion in Clinical Nutrition and Metabolic Care·Armand KrikorianEtie S Moghissi
Oct 15, 2010·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Christopher A NewtonGuillermo E Umpierrez
May 10, 2011·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Kathleen DunganKwame Osei
Jul 1, 2011·Diabetes Technology & Therapeutics·Lelio MorviducciUNKNOWN CSII Study Group Of Lazio Region, Italy
Nov 17, 2011·Current Diabetes Reports·Ariana Pichardo-Lowden, Robert A Gabbay
May 12, 2012·Endocrinology and Metabolism Clinics of North America·Marie E McDonnell, Guillermo E Umpierrez
May 30, 2012·Journal of Cardiac Surgery·Marie E McDonnellHarold L Lazar
Jun 12, 2012·The Journal of Clinical Endocrinology and Metabolism·Elisa HsiaBoris Draznin
Aug 24, 2012·JPEN. Journal of Parenteral and Enteral Nutrition·Roland N DickersonRex O Brown
Sep 25, 2012·Metabolism: Clinical and Experimental·Nicole C Dombrowski, Dennis G Karounos

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Citations

Apr 20, 2017·Journal of Molecular Endocrinology·J Jason CollierSusan J Burke
Mar 5, 2017·Reviews in Endocrine & Metabolic Disorders·Vishnu GarlaLillian F Lien
Nov 4, 2017·Current Diabetes Reports·Susan Shapiro BraithwaiteOluwakemi T Soetan
May 3, 2016·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Sandra Bunn, Margo Halm
Mar 28, 2018·Current Diabetes Reports·Susan Shapiro BraithwaiteOluwakemi T Soetan
Jan 25, 2016·Current Diabetes Reports·Rodolfo J Galindo, Amisha Wallia
Jan 31, 2021·The Lancet. Diabetes & Endocrinology·Francisco J PasquelGuillermo E Umpierrez

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