874-P: Use of Weight-Based Insulin to Reduce Hyperglycemia when Transitioning to Subcutaneous Insulin in MICU

Introduction: Hyperglycemia often occurs after transition from intravenous insulin infusion (IVII) to subcutaneous insulin (SCI) in the medical intensive care unit (MICU). We assessed whether addition of weight-based basal (timed with IVII) and bolus insulin (added after) improves glycemic control after transition. Methods: This prospective study included 64 MICU patients on IVII for 24+ hrs. Exclusions were ESRD, T1DM, and active use vasopressors. Intervention arm received weight-based basal insulin (0.2-0.25 units/kg) every day on the IVII after enrollment and weight-based bolus insulin added post IVII. Control arm was current care. Glycemic control up to 48 hours post IVII was compared. Results: Patients had mean age of 59±15 (SD) years, 46% were male, and 78% had prior DM. Higher steroid use in control arm (34% vs.. 12%, p=0.046) but otherwise arms were similar (AKI/CKD, presence DM, illness severity, NPO post IVII). Blood glucose was significantly lower in the intervention arm starting 12 hrs post IVII (Table 1). The intervention arm had similar hypoglycemia frequency (