✦ LIBER ✦

Triple-B (basal-bolus-booster) subcutaneous insulin regimen: a pragmatic approach to managing hospital inpatient hyperglycaemia

✍ Scribed by Perera, NJ ;Harding, AJ ;Constantino, MI ;Molyneaux, L ;McGill, M ;Chua, EL ;Twigg, SM ;Ross, GP ;Yue, DK

Book ID: 104513142
Publisher: John Wiley and Sons
Year: 2011
Tongue: English
Weight: 498 KB
Volume: 28
Category: Article
ISSN: 1357-8170
DOI: 10.1002/pdi.1612

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✦ Synopsis

Abstract

The objective of this study was to introduce a practical insulin protocol for hospital inpatients with hyperglycaemia.

The acronym BBB emphasised the insulin supply in three components, basal, bolus (nutrition correction) and booster (blood glucose level [BGL] correction). The insulin dosage was based on patient weight and adjusted to BGL at pre‐specified times. Compliance of BGL measurements and insulin injections, and efficacy were evaluated prospectively. Fifty‐seven hospital inpatients with significant hyperglycaemia were treated and compared with 45 historical controls (with similar age, HbA~1c~ and diabetes duration) treated with sliding scale insulin (SSI).

The BGL (mean±SD) was significantly lower during BBB treatment (11.7±2.6 vs 13.6±2.4mmol/L; p<0.0001), while episodes of hyperglycaemia were less (median: 3 [IQR 1–8] vs 7 [IQR 4–12]; p=0.001). Patients who experienced hypoglycaemia were also less likely to have a repeat episode with the BBB protocol (median: 1 [IQR 1–3] vs 3 [IQR 2–4.5]).