Sliding Scale Insulin Use in Nursing Homes Before and After Onset of the COVID-19 Pandemic.
Darlene P Tat, Andrew R Zullo, Vincent Mor and 1 others
PMID 38307122WHAT IT FOUND
Sliding-scale insulin was common among nursing home residents, especially with other diabetes medicines, and many had low or high blood sugar readings.
Use fell just after pandemic onset, then followed earlier trends.
Key findings
01Among 129,829 nursing home residents identified with sliding-scale insulin use, 36.1% received it alone and 63.9% received it with another diabetes medication.
02Within 30 days after starting sliding-scale insulin, 25.6% had a blood glucose reading below 70 mg/dL and 61.6% had a reading above 300 mg/dL.
03The analysis found 42.5 fewer sliding-scale users per 1000 insulin users immediately after pandemic onset, but the longer-term trend after onset did not change significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study could not assess the dose of sliding-scale insulin that residents received. Longer-term glucose control by hemoglobin A1c was not available for many residents in the electronic records. Because this was a descriptive study, it could not show that sliding-scale insulin caused low or high glucose readings. Residents' exposure to sliding-scale insulin before nursing home admission was not measured. The data came from 12 nursing home chains using one electronic record system, so they may not represent all nursing homes.
Declared interests
The supplied metadata lists research support from NIH, U.S. government non-PHS, and non-U.S. government sources. No author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not conclude that sliding-scale insulin caused the low and high glucose readings. The study was descriptive, did not measure insulin doses or longer-term control, and compared residents who were already receiving different diabetes regimens.