Comparison of the Efficacy and Safety of Two Different Insulin Infusion Protocols in the Medical Intensive Care Unit

Abstract

The study showed that by having less intensive glycemic goals, goal BG levels can achieved faster and the rate of severe hypoglycemia can decrease.

Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units

“…The sampling interval remains a critical point for our IIP, like all other IIPs, as it involves a higher workload for nurses and is a nuisance to patients, especially during the night. The median interval between consecutive measurements of 1.8 h in our study is similar to or even longer than that reported by many studies with either paper-based 7–9,27,29,30 or computer-assisted 38,39 protocols. One-fourth of our BG intervals were longer than 2 h, mostly at night.…”

“…The use of DDDiv 140–180 IIP, like the DDDiv 100–139, rapidly achieved the target and maintained it in a large proportion of the measurements, up to 60%, better than with other IIPs with similar BG targets, which range from 36 to 45%. 27–30…”

“…[24][25][26] The use of DDDiv 140-180 IIP, like the DDDiv 100-139, rapidly achieved the target and maintained it in a large proportion of the measurements, up to 60%, better than with other IIPs with similar BG targets, which range from 36 to 45%. [27][28][29][30] Considering that recent European guidelines for the management of ACS recommend avoiding both hypo-and hyperglycaemia, 12,13 with our protocol BG between 90 and 200 mg/dL was obtained in over 95% of all hourly BG after the first value on target.…”

“…The new version of DDDiv140-180, like other IIPs with similar higher BG targets, 10,[27][28][29][30] has the advantage of a very low incidence of hypoglycaemic events, already low in DDDiv 100-139. 18 In our population, BG <70 mg/dL was observed once every 1695 h of insulin infusion, one of the lowest incidences reported, five to eight times lower than with other IIPs with similar BG targets.…”

“…18 In our population, BG <70 mg/dL was observed once every 1695 h of insulin infusion, one of the lowest incidences reported, five to eight times lower than with other IIPs with similar BG targets. [27][28][29][30] The hypoglycaemic episodes were all asymptomatic, with no clinical consequences, and were corrected within 15 minutes.…”