Implementation of subcutaneous insulin protocol for non-critically ill hospitalized patients in Andalusian tertiary care hospitals

Abstract Introduction In 2009, the Andalusian Society of Endocrinology and Nutrition designed a protocol for subcutaneous insulin treatment in hospitalized non-critically ill patients (HIP). Objective To analyze implementation of HIP at tertiary care hospitals from the Andalusian Public Health System. Method A descriptive, multicenter study conducted in 8 tertiary care hospitals on a random sample of non-critically ill patients with diabetes/hyperglycemia (n = 306) hospitalized for ≥48 h in 5 non-surgical (SM) and 2 surgical (SQ) departments. Type 1 and other specific types of diabetes, pregnancy and nutritional support were exclusion criteria. Results 288 patients were included for analysis (62.5% males; 70.3 ± 10.3 years; 71.5% SM, 28.5% SQ). A scheduled subcutaneous insulin regimen based on basal-bolus-correction protocol was started in 55.9% (95%CI: 50.5–61.2%) of patients, 63.1% SM vs 37.8% SQ ( p p Conclusions Strategies are needed to improve implementation of the inpatient subcutaneous insulin protocol, particularly in surgical departments. Sliding scale insulin is still the most common alternative to insulin regimen based on basal-bolus-correction scheduled insulin. Metabolic control assessment during hospitalization should be encouraged.