Bedtime insulin supplementation does not improve glycemic control in type 2 diabetes patients

Insulin supplementation does not improve bedtime hyperglycemia in patients with type 2 diabetes, according to a study published online ahead of print in Diabetes Care. Clinical guidelines recommend the use of supplemental doses of rapid-acting insulin before meals and at bedtime for correction of hyperglycemia, but the efficacy and safety of this recommendation, have not been tested in the hospital setting, according to background information provided in the study.

Researchers from Emory University in Atlanta randomized 206 general medicine and surgery patients with type 2 diabetes treated with a basal-bolus regimen to receive either supplemental insulin at bedtime for blood glucose >7.8 mmol/L or no supplemental insulin (n = 100) except for BG >19.4 mmol/L.

The researchers found no differences in mean fasting blood glucose between the two groups. "We conclude that routine use of bedtime insulin supplementation is not indicated for management of inpatients with type 2 diabetes," the researchers wrote. -by Rebecca Zumoff