Inpatient Diabetes on Corticosteroids

Despite a significant problem with out-of-control glucose levels in patients with diabetes
receiving corticosteroids for a variety of illnesses, there are no published protocols
addressing how to adequately treat corticosteroid-induced hyperglycemia. Investigators
propose to test a protocol using scheduled dosing of NPH (Neutral protamine Hagedorn) insulin
for inpatients with diabetes receiving corticosteroids. NPH insulin action is ideally timed
to counteract corticosteroid-induced hyperglycemia, and the dose is added to the patient's
usual insulin regimen and timed to correspond to the corticosteroid dosing regimen.
Investigators will prospectively enroll eligible consented patients with diabetes who are
receiving corticosteroids as part of their treatment in a large county hospital, will
randomize them to intervention or control groups, and will monitor their glucose levels
during their inpatient stay. The protocol will demonstrate improved control of glucose levels
with minimal risk of hypoglycemia, and will provide a practical and readily implementable
protocol using NPH insulin as therapy for corticosteroid-induced diabetes.