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Transitioning Safely from Intravenous to Subcutaneous Insulin

  • Hospital Management of Diabetes (GE Umpierrez, Section Editor)
  • Published:
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Abstract

The transition from intravenous (IV) to subcutaneous (SQ) insulin in the hospitalized patient with diabetes or hyperglycemia is a key step in patient care. This review article suggests a stepwise approach to the transition in order to promote safety and euglycemia. Important components of the transition include evaluating the patient and clinical situation for appropriateness, recognizing factors that influence a safe transition, calculation of proper SQ insulin doses, and deciding the appropriate type of SQ insulin. This article addresses other clinical situations including the management of patients previously on insulin pumps and recommendations for patients requiring glucocorticoids and enteral tube feedings. The use of institutional and computerized protocols is discussed. Further research is needed regarding the transition management of subgroups of patients such as those with type 1 diabetes and end-stage renal disease.

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Conflict of Interest

Kathryn Evans Kreider declares that she has no conflict of interest.

Lillian F. Lien has been a consultant for Merck, Eli Lilly, Novo Nordisk, and Sanofi-Aventis; has received honoraria from the American College of Physicians; and has received royalties from Springer Inc. for a book she edited.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Duke University Medical Center, Box 3922, Durham, NC, 27710, USA

    Kathryn Evans Kreider

  2. Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA

    Lillian F. Lien

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  1. Kathryn Evans Kreider
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Correspondence to Kathryn Evans Kreider.

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This article is part of the Topical Collection on Hospital Management of Diabetes

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Kreider, K.E., Lien, L.F. Transitioning Safely from Intravenous to Subcutaneous Insulin. Curr Diab Rep 15, 23 (2015). https://doi.org/10.1007/s11892-015-0595-4

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