{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:42:23Z","timestamp":1787654543632,"version":"build-2736575974"},"reference-count":32,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014712","name":"National Institute for Dementia Research","doi-asserted-by":"publisher","award":["GNT1189788"],"award-info":[{"award-number":["GNT1189788"]}],"id":[{"id":"10.13039\/501100014712","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["NHF102453"],"award-info":[{"award-number":["NHF102453"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2025,10,20]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Prednisolone is widely prescribed to hospitalized patients for a range of conditions. Up to 40% of hospitalized patients treated with prednisolone will experience hyperglycemia. Current guidelines recommend management of acute hyperglycemia in hospitalized patients with subcutaneous basal-bolus insulin (BBI), but the optimum treatment strategy has not been defined. We aimed to assess the performance of an individualized subcutaneous BBI regimen for management of prednisolone-associated hyperglycemia in hospitalized patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 23 adult inpatients prescribed subcutaneous BBI based on total daily insulin requirements estimated from a 24-hour intravenous insulin infusion and 24 historical controls who were prescribed a standard, institutional weight-based subcutaneous BBI to treat prednisolone-associated hyperglycemia. The primary endpoint was the mean 24-hour point-of-care (POC) glucose concentration on day 1. Exploratory end points included proportion of glucose measurements within target glucose range, SD of glucose, and stress hyperglycemia ratio (SHR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no significant difference in mean POC glucose on day 1 between participants prescribed an individualized insulin regimen and patients receiving a standard body weight-based BBI regimen (10.7\u00b13.4 vs 11.9\u00b13.2\u2009mmol\/L, p=0.07). Proportion of glucose measurements within the target glucose range was higher (52.0\u00b14.8\u2009vs 37.0\u00b14.5%, p=0.0007) and SD for glucose lower (3.1\u00b11.5 vs 4.0\u00b11.6, p=0.04) on day 1 of individualized BBI insulin. Over 2\u2009days, there was an increase in glucose SD in both groups, but no significant difference in mean glucose and SHR between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individualizing a subcutaneous BBI regimen for management of prednisolone-associated hyperglycemia was associated with a modest reduction in mean POC glucose, an increased proportion of blood glucose measurements within the target range, and reduced short-term glycemic variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12618001211257.<\/jats:p>\n                  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