Clinical Audit of Inpatient Insulin Prescribing Patterns and Glycemic Outcomes: Sliding Scale Insulin Versus Basal–Bolus Therapy
DOI:
https://doi.org/10.70749/ijbr.v4i4.3060Keywords:
Inpatient Hyperglycemia, Sliding Scale Insulin, Basal–bolus Insulin, Glycemic Control, Clinical Audit, Hypoglycemia, Hospital Stay.Abstract
Background: Inpatient hyperglycemia is associated with adverse clinical outcomes and requires effective management. Despite evidence favoring basal–bolus insulin (BBI) therapy, sliding scale insulin (SSI) remains widely used in many hospitals. Objective: To evaluate inpatient insulin prescribing patterns and compare glycemic outcomes between SSI and BBI therapy during a third audit cycle. Methods: TThis re-audit of clinical practices was carried out at Lady Reading Hospital between June and December 2025 The study evaluated 482 insulin-treated patients with hyperglycemia admitted to hospital. Insulin type, blood glucose (BG) control, hypoglycemia, length of stay (LOS) and mortality were reviewed. Comparisons between SSI and BBI were made using appropriate tests of significance (p ≤ 0.05). Results: 64% of patients received BBI while 36% of patients used SSI. BBI use was linked to improved glycemic control (average glucose 162 ±35 mg/dL vs. 198 ± 42 mg/dL), reduced hypoglycemia (6% vs. 15%) and shorter hospital stay (3.5 vs. 4.9 days) over SSI (p<0.05). BBI was associated with a lower (insignificant) mortality rate (2% vs. 4%). Conclusion: Basal–bolus insulin therapy demonstrates superior clinical outcomes compared to SSI. Sustained audit interventions effectively improved prescribing practices and patient outcomes.
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