"Reactive" Approach vs. "Proactive" Approach
to Diabetes Management
"Reactive" Approach
|
"Proactive" Approach
|
Figure 1: ISS vs. BBI
Image from: Schmeltz LR. Management of Inpatient Hyperglycemia.Lab Med 2011;42(7):427-434
The above image is an example of a patient switched from traditional insulin sliding scale to basal-bolus insulin regimen. When the patient was on the traditional insulin sliding scale, the patient had large glycemic variabiltiy ("roller coaster" effect). As you can imagine, large variation is blood glucose levels can exacerbate hyperglycaemia as well as hypoglycaemia <1>. By switching to basal-bolus insulin regimen, there was significant reduction in the fluctuation of the patient's blood glucose levels. <2>
Reference:
1. Umpierrez GE, Smiley D, Zisman A. et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes (RABBIT trial). Diabetes Care 2007;30: 2181– 2186
2. Schmeltz LR. Management of Inpatient Hyperglycemia.Lab Med 2011;42(7):427-434
1. Umpierrez GE, Smiley D, Zisman A. et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes (RABBIT trial). Diabetes Care 2007;30: 2181– 2186
2. Schmeltz LR. Management of Inpatient Hyperglycemia.Lab Med 2011;42(7):427-434