This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Most patients with insulin dependent diabetes require a long-acting insulin and a short-acting insulin with meals. High blood sugars can decrease the body's ability to respond to an acute illness. Various studies have shown that good blood sugar control while in the hospital can decrease the rate of complications and death. It is currently not known which long-acting insulin best controls blood glucose levels in hospitalized diabetic patients. We shall be comparing two types of long acting insulin: Lantus and NPH, in patients with diabetes undergoing surgery. We are investigating whether one type of insulin is better than another in controlling blood glucose levels. About one hundred people will take part in this study. Once they are admitted, the patients shall be assigned to one of 2 research treatment groups - to receive either NPH insulin or Lantus insulin as their long acting insulin. Both of these types of insulin are approved by the Food and Drug Administration (FDA) for clinical use and are not experimental medications. All subjects will receive Humalog insulin as the short acting insulin with meals. Insulin dosage will be calculated based on weight. A research nurse will administer the insulin. We shall monitor blood glucose levels by fingersticks every four hours. The times blood glucose levels shall be tested are 6 AM, 10 AM, 2 PM, 6 PM, 8 PM, 10 PM and 2AM. The insulin dosage shall be altered based on these levels. The Endocrinology Doctors-Dr Clement and Dr Bowen-Wright will do all insulin calculations. The study shall last for a minimum of three days and a maximum of five days. If the patients' are still in hospital after this time, the endocrinology consult team will manage their diabetes.
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