Abstract

Background: Glucocorticoids are widely prescribed for acute and chronic conditions but frequently cause hyperglycaemia, which increases infection risk, delays recovery, and prolongs hospital stay. Insulin is the treatment of choice, but optimal regimens in steroid-induced hyperglycaemia remain uncertain. Premixed insulin analogues may offer practical advantages, yet evidence comparing different premix ratios is limited. Aim: To evaluate and compare the efficacy and safety of biphasic Aspart 30/70 versus biphasic lispro 50/50 in managing glucocorticoid-induced hyperglycaemia in hospitalised patients. Methods: This prospective, randomised, open-label trial enrolled 60 hospitalised patients with glucocorticoid-induced hyperglycaemia (random blood glucose >200 mg/dL after ≥3 days of prednisolone or dexamethasone). Participants were randomised 1:1 to receive biphasic Aspart 30/70 or biphasic Lispro 50/50, with individualised titration to achieve pre-specified targets (