Comparative Analysis between Weight Based Insulin (WBI) and Sliding Scale Insulin Orders

Abstract

Purpose:  This evidenced based practice initiative was piloted on admissions to Medical and Surgical unit populations to evaluate the blood glucose control based on administration of insulin utilizing weight based order sets as compared to sliding scale insulin order sets.

Design of study:  Randomized selection of patients to receive either WBIO or Non-WBIO, National Hospital and Medical Center, Lahore, Pakistan. July to December of 2008.

Material and Method:  Patients with uncontrolled Diabetes Mellitus who were admitted to medical and surgical unit for all causes were inducted in the study except patients who were already under control on either Insulin or oral hypoglycemic agents. Finger stick glucometer reading were used and patients were randomized to be either on weight based insulin orders or Non-weight based insulin order, the order forms were freely available for use.

Results:  Over the period of 6 months 155 patients were assigned to receive WBIO and 154 were assigned to receive Non-WBIO. The patients were kept in the study for a maximum of 5 days. There was significant difference in episodes of Hyperglycemia more marked in patients receiving Non-WBIO versus WBIO. There was no significant difference in episodes of Hypoglycemia.

Conclusion:  WBIO had better glycemic control and equal hypoglycemic episodes as compare to Non-WBIO. Recommends usage of weight based insulin order sheets (WBIO) while the patients are hospitalized.

Key word:  WBIO (Weight Based Insulin Order), Non-WBIO (Non Weight Based Insulin Order).