Hospital Management of Hyperglycemia Study of Insulin Glargine Plus Insulin Lispro Versus Human Regular Insulin

This study involves a comparison of 2 methods for administering subcutaneous insulin therapy
to non-critically ill adult patients with hyperglycemia and without known history of
diabetes who are admitted to non-ICU general medical hospital services. Basal-bolus
therapy, considered the gold standard for glucose control in patients with known diabetes,
will be compared with sliding scale insulin, a commonly used method of glucose control
(prevailing standard practice) in hospitalized patients. In this study, basal-bolus therapy
will consist of once-daily glargine plus lispro 3 to 4 times daily adjusted to achieve
pre-meal capillary plasma glucose < 140 mg/dL and bedtime capillary plasma glucose < 180
mg/dL for patients who are eating (predose plasma glucose < 140 mg/dL for patients with nil
per os [NPO] orders); sliding scale insulin will be administered using human regular insulin
4 times daily as needed adjusted to achieve predose capillary plasma glucose target < 140
mg/dL in patients who are eating or have NPO orders.