13. Pauta de insulina móvil intensiva  vs pauta bolo-basal en pacientes  diabéticos tipo II hospitalizados

Natalia Sánchez Prida

Natalia Sánchez Prida Medicina Familiar y Comunitaria. Hospital Universitario 12 de Octubre

Palabras clave: Diabetes Mellitus, Hipoglucemia

Abstract

La pauta móvil de insulina añadida a la pauta bolo-basal en forma de escala correctora, se ha asociado a menor morbimortalidad en pacientes diabéticos tipo II hospitalizados en planta convencional. Sin embargo, conlleva mayor probabilidad de hipoglucemia iatrogénica y complejidad en su administración, por lo que se podría inclinar la balanza a favor del uso de una pauta bolobasal menos rígida en pacientes con hiperglucemia moderada.

The intensive sliding scale insulin treatment added to the bolus-basal regimen in the form of a corrective scale leads to less morbimortality in non-ICU patients with type 2 diabetes. However, it brings higher probability of iatrogenic hypoglycemia and a more complex administration. Therefore, the basal-bolus insulin regimen could be a better option in patients with moderate hyperglycemia.

Recibido: 06 Abril 2023
Revisión: 11 Abril 2023
Aceptado: 05 Mayo 2023

Citas

Vol 13 N17; págs. 982-986. 2020. Hernández E.L., de Windt F., Fernández Truchaud A.

Therapeutic protocol of the diabetic patient in special situations: hospital admission, surgical

intervention, procedures, fever and steroids. Enfermedades endocrinológicas y metabólicas (V)

Diabetes mellitus (II). Medicine.

DOI: 10.1016/j.med.2020.09.025

Vol 11 N10; pág. 2813. 2022. Batule S., Ramos A., Pérez-Montes de Oca A. Comparison of

Glycemic Variability and Hypoglycemic Events in Hospitalized Older Adults Treated with Basal

Insulin plus Vildagliptin and Basal-Bolus Insulin Regimen: A Prospective Randomized Study.

Journal of Clinical Medicine.

Doi: https://doi.org/10.3390/jcm11102813

Vol 2018 N11; pág. CD011296. 2018. Colunga Lozano L.E., Gonzalez Torres F.J., Delgado‐

Figueroa N., Gonzalez Padilla D.A., Hernandez A.V., Roman Y., Cuello‐García C.A. Sliding

scale insulin for noncritically ill hospitalised adults with diabetes mellitus. Cochrane Database of

Systematic Reviews.

Doi: https://doi.org/10.1002%2F14651858.CD011296.pub2

Vol 14 N4; págs 233-239. 2020. Gómez A.M., Imitola Madero A., Henao Carrillo D.C., Rondón

M. Hypoglycemia Incidence and Factors Associated in a Cohort of Patients With Type 2 Diabetes

Hospitalized in General Ward Treated With Basal Bolus Insulin Regimen Assessed by Continuous

Glucose Monitoring. Journal of Diabetes Science and Technology.

Doi: https://doi.org/10.1177/1932296818823720

Vol 5 N8; Pág bvab101. 2021. Sadhu A.R., Patham B., Vadhariya A., Chikermane S.G., Johnson

M.L. Outcomes of "Real-World" Insulin Strategies in the Management of Hospital Hyperglycemia.

Journal of the Endocrine Society.

Doi: https://doi.org/10.1210/jendso/bvab101