{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T13:13:59Z","timestamp":1778937239084,"version":"3.51.4"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T00:00:00Z","timestamp":1582588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Twice\/day dosing of insulin glargine has been used to treat hyperglycemia in clinical practice; however, data supporting its use in the critically ill population are lacking. This study was designed to evaluate the safety and efficacy of twice\/day insulin glargine in critically ill patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted in adult patients admitted to the intensive care units between February 2013 and June 2017 who received insulin glargine twice\/day or 40 units or more once\/day for 48\u00a0hours or longer. Post cardiovascular surgery patients were excluded. Data were collected for up to 14 patient\u2010days. The efficacy outcomes included the incidence of hyperglycemia (blood glucose [BG] above 180\u00a0mg\/dl), predose hyperglycemia rate (BG above 180\u00a0mg\/dl within 4\u00a0hrs before the dose), and BG variability (standard deviation). The safety outcome was assessed by the development of hypoglycemia (BG below 70\u00a0mg\/dl).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 58 patients (twice\/day\u00a0=\u00a023; once\/day\u00a0=\u00a035) were included in the analysis. Demographics were similar between the groups including history of diabetes mellitus, baseline hemoglobin A<jats:sub>1C<\/jats:sub>, and home insulin use. No difference was observed between the twice\/day and once\/day groups in the mean BG (153 vs 154\u00a0mg\/dl, p=0.95, respectively), and BG variability (46 vs 44\u00a0mg\/dl, p=0.29, respectively). Although the overall incidence of hyperglycemia was similar between twice\/day and once\/day groups (96% vs 97%, p=1.00, respectively), the twice\/day group had a significantly lower predose hyperglycemia rate (twice\/day 0.27 vs once\/day 0.43, p=0.02). Additionally, the twice\/day group did not experience an increased incidence of hypoglycemia (twice\/day 23% vs once\/day 34%, p=0.57) or hypoglycemia without having anything by mouth (twice\/day 0% vs once\/day 9%, p=0.27).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study demonstrating that twice\/day insulin glargine reduced the rate of predose hyperglycemia without increasing the risk of hypoglycemia in critically ill patients. A large randomized study is needed to confirm the safety and efficacy of twice\/day glargine in the critically ill.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2373","type":"journal-article","created":{"date-parts":[[2020,1,29]],"date-time":"2020-01-29T19:19:51Z","timestamp":1580325591000},"page":"186-190","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Insulin Glargine in Critically ill Patients: Once\/Day versus Twice\/Day Dosing"],"prefix":"10.1002","volume":"40","author":[{"given":"Marlena A.","family":"Fox","sequence":"first","affiliation":[{"name":"Pharmacy Services Orlando Regional Medical Center Orlando Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8990-1061","authenticated-orcid":false,"given":"Melanie C.","family":"Perry","sequence":"additional","affiliation":[{"name":"Pharmacy Services Orlando Regional Medical Center Orlando Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Liu\u2010DeRyke","sequence":"additional","affiliation":[{"name":"Pharmacy Services Orlando Regional Medical Center Orlando Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12178"},{"issue":"3","key":"e_1_2_6_3_1","first-page":"489","article-title":"Insulin therapy for type 2 diabetes: rescue, augmentation, and replacement of beta cell function","volume":"70","author":"Mayfield JA","year":"2004","journal-title":"Am Fam Physician"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.8.1479-a"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01913.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.2.632"},{"issue":"2","key":"e_1_2_6_7_1","first-page":"42","article-title":"Benefits of twice\u2010daily injection with insulin glargine: a case report and review of the literature","volume":"103","author":"Youssef D","year":"2010","journal-title":"Tenn Med"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.4236\/jdm.2012.22032"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2018.12.002"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.2373","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2373","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/phar.2373","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2373","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T12:34:15Z","timestamp":1761050055000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,25]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/phar.2373"],"URL":"https:\/\/doi.org\/10.1002\/phar.2373","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,25]]},"assertion":[{"value":"2020-02-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}