Assessment of the implementation of an insulin therapy protocol in a regional reference hospital in the interior of Santa Catarina

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Introduction: Inpatient hyperglycemia is defined by blood glucose levels above 180 mg/dL. This condition is related to complications, such as increased morbidity and mortality and prolonged hospital stays. The therapeutic approach involves insulin therapy with a regimen using basal, prandial and correctional insulins, generally setting a glycemic target of between 100 and 180 mg/dL. Objective: To analyze the management of hospitalized patients with hyperglycemia, given the implementation of an insulin therapy protocol. Methods: This is an observational and analytical study with a cross-sectional and retrospective epidemiological design, with data collected by analyzing the electronic medical records of hospitalized patients with hyperglycemia between May and October 2024. Results: The total number of patients was divided into groups before (n = 38) and after (n = 25) the implementation of the protocol. The sliding scale insulin was the main treatment used in the first group (34.21%) and the basal-bolus or basal-correction insulin regimen in the second (44.00%). There was an increase in the detection of hyperglycemia in the second group (56.17%) compared to the first (29.14%) (p = 0.046). Hypoglycemia was reported in 4 patients in the first group and in 6 patients in the second. The average length of stay was 7.05±5.39 days in the first group and 6.14±5.51 days in the second. Conclusions: This study demonstrated an increase in hyperglycemia after the protocol was implemented at the evaluated hospital. Measures are also needed to improve protocol use to optimize patient care.

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