Physiological Versus Reactive Insulin Dosing in Non-Critically Ill Hospitalized Patients: Effects on Glycemic Control and Hypoglycemia Risk
Advisor(s)
Zachariah Shumaker
Confirmation
1
Document Type
Poster
Location
ONU McIntosh Center; Activities Room
Start Date
24-4-2026 11:00 AM
End Date
24-4-2026 11:50 AM
Abstract
Abstract
Problem: Inpatient hyperglycemia is associated with increased morbidity, mortality, and prolonged hospital stays. Although evidence supports physiological insulin dosing strategies that closely mimics the body’s endogenous insulin secretion, it is not widely implemented in the inpatient setting. Instead, reactive insulin dosing methods remain more commonly used.
Purpose: The purpose of this study is to compare the effectiveness and safety of physiological insulin dosing to reactive insulin dosing in non-critically ill hospitalized patients with type 2 diabetes mellitus.
Methods: This prospective, single-center, randomized controlled trial will use an open-label design. Eligible participants will be adults admitted to a medical or surgical unit with a diagnosis of type 2 diabetes mellitus and inpatient hyperglycemia. Participants will be randomized into either the reactive dosing group or the physiological dosing group. Data collected will include blood glucose prior to meals and at bedtime, carbohydrate intake, and insulin administration. Primary outcomes will include mean daily glucose and percentage of time in range (100-180 mg/dL). Secondary outcomes will include occurrence of hypoglycemia (< 70 mg/dL), severe hypoglycemia (< 54 mg/dL), and length of hospital stay.
Conclusion: It is hypothesized that the physiological insulin dosing method will provide better glycemic control demonstrated by lower mean daily glucose levels and higher percentage of time in range, while not increasing the incidence of hypoglycemia when compared to reactive dosing. Findings may support a realistic, standardizable insulin dosing method that improves patient outcomes and enhances nursing practice.
Recommended Citation
Holt, Olivia F., "Physiological Versus Reactive Insulin Dosing in Non-Critically Ill Hospitalized Patients: Effects on Glycemic Control and Hypoglycemia Risk" (2026). ONU Student Research Colloquium. 47.
https://digitalcommons.onu.edu/student_research_colloquium/2026/Posters/47
Open Access
Available to all.
Physiological Versus Reactive Insulin Dosing in Non-Critically Ill Hospitalized Patients: Effects on Glycemic Control and Hypoglycemia Risk
ONU McIntosh Center; Activities Room
Abstract
Problem: Inpatient hyperglycemia is associated with increased morbidity, mortality, and prolonged hospital stays. Although evidence supports physiological insulin dosing strategies that closely mimics the body’s endogenous insulin secretion, it is not widely implemented in the inpatient setting. Instead, reactive insulin dosing methods remain more commonly used.
Purpose: The purpose of this study is to compare the effectiveness and safety of physiological insulin dosing to reactive insulin dosing in non-critically ill hospitalized patients with type 2 diabetes mellitus.
Methods: This prospective, single-center, randomized controlled trial will use an open-label design. Eligible participants will be adults admitted to a medical or surgical unit with a diagnosis of type 2 diabetes mellitus and inpatient hyperglycemia. Participants will be randomized into either the reactive dosing group or the physiological dosing group. Data collected will include blood glucose prior to meals and at bedtime, carbohydrate intake, and insulin administration. Primary outcomes will include mean daily glucose and percentage of time in range (100-180 mg/dL). Secondary outcomes will include occurrence of hypoglycemia (< 70 mg/dL), severe hypoglycemia (< 54 mg/dL), and length of hospital stay.
Conclusion: It is hypothesized that the physiological insulin dosing method will provide better glycemic control demonstrated by lower mean daily glucose levels and higher percentage of time in range, while not increasing the incidence of hypoglycemia when compared to reactive dosing. Findings may support a realistic, standardizable insulin dosing method that improves patient outcomes and enhances nursing practice.