Hospital Insulin Protocol Aims for Glucose Control in Corticosteroid-induced Hyperglycemia

The overall study objective of this research is to establish the efficacy and assure the
safety of achieving glycemic control in hospitalized patients who receive greater than
physiologic doses of steroids. This study will compare 2 methods of achieving glycemic
control in hospitalized patients who develop steroid-induced hyperglycemia (blood glucose
(BG) >180 mg/dL): 1) a study-specific steroid NPH dosing algorithm plus standard recommended
care (Experimental group) vs. 2) the standard recommended care (Methodist Hospital Complete
Insulin Orders (Control group).

Inclusion Criteria:

- Men or women aged ≥18 years who receive steroids in doses greater than physiologic
replacement levels of ≥ 10 mg Prednisone or its equivalent of dexamethasone or
methylprednisolone.

- Have signed the consent form for the study

- Have a BG > 180 mg/dL any time during the first 24 hour of steroid administration that
is above physiological replacement ( ≥ 10 mg Prednisone or equivalent)

- Are scheduled to be in hospital ≥ 2 days.

Exclusion Criteria:

- Unable to read or understand English

- History of psychiatric disability affecting informed consent or compliance with drug
intake

- Type 1 diabetes

- Acute or chronic renal failure (creatinine clearance < 30 mL/min estimated by method
of Cockcroft and Gault)

- Patients in Hospice Care

- Age <18 years

- Previously enrolled in this study.

- Not appropriate for the steroid protocol in judgment of the principal investigator
and/or attending physician.