Transition From Intravenous to Subcutaneous Insulin in Critically Ill Adults

Doolin, Meagan; Walroth, Todd; Harris, Serena; Whitten, Jessica; Fritschle-Hilliard, Andrew C.

doi:10.1177/1932296816629985

Cited by 11 publications

(20 citation statements)

References 17 publications

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“…Our findings raised concerns about the nutritional status of the patients and the methods used as discussed in the literature [8, 9, 39]. In our research, insulin infusion method was used for one patient and the NICE-SUGAR target was achieved in-line with published data [6, 11]. While, mixed insulin method did not achieve the target glycaemic range as already reported by Marik P.E et al [10].…”

Section: Discussionsupporting

confidence: 72%

“…The cardiac unit had an average of 2.25 pumps±1.39 [range: 1 – 5]. The mixed ICUs were more equipped with an average of 2.86 pumps±0.86 [range: 2-5] in Room-B, 3.15 pumps±1.03 [1–6] in CCR1 and 3.57 pumps±1.6 [1–6] in CCR2.…”

Section: Resultsmentioning

confidence: 99%

“…Sustained training programs on hyperglycaemia control for ICU healthcare staff are indicated as well as the availability of local guidelines on glycaemia control in all ICUs is needed. For best practice in ICUs, the use of intravenous insulin infusion targeting NICE-SUGAR blood glucose level should be recommended firstly, then, switching to basal-bolus method with nutritional support when patients get stable [6,39].…”

Section: Discussionmentioning

confidence: 99%

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Practice of Hyperglycaemia Control in Intensive Care Units of the Military Hospital, Sudan – Needs of a Protocol

El‐Raheem

Abdallah²,

Noma³

2020

Preprint

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Hyperglycaemia is a major risk factor in critically ill patients as it leads to adverse outcomes and mortality in diabetic and non-diabetic patients. The target blood glucose remained controversial; this study aimed to contribute in assessing the practice of hyperglycaemia control in intensive care units of Khartoum Military Hospital. Furthermore, it proposed a protocol for hyperglycaemia control based on findings. A hospital-based cross-sectional study assessed the awareness and practice towards hyperglycaemia management in a sample of 83 healthcare staff selected through stratified random sampling technique. In addition, 55 patients were enrolled, through quota sampling, after excluding those with diabetic ketoacidosis, hyperosmolar-hyperglycaemic state and patients < 18 years. A self-administrated questionnaire enabled to collect data from healthcare staff, patients data were extracted from medical records. SPSS 23 was used to analyse the collected data. Chi-square and ANOVA tests assessed the association among variables. All statistical tests were considered statistically significant when p < 0.05. The training on hyperglycaemia control differed statistically (p= 0.017) among healthcare staff. The target glycaemic level (140-180 mg/dl) was knew by 11.1% of the study participants. Neither the knowledge nor the practice of hyperglycaemia control methods differed among staff (p> 0.05). The use of sliding scale was 79.3% across the ICUs with a statistically significant difference (p= 0.002). 31.5% of patients had received glycaemic control based on different methods and 11.8% were in the targeted blood glucose level. Sliding scale was the prevalent method used by doctors (71.4%) and nurses (81.6%). A patient benefited from insulin infusion method, which achieved the NICE-SUGAR target. The poor knowledge and lack of awareness towards hyperglycaemia monitoring led to inappropriate implementation of glycaemia control methods across the Military Hospital ICUs. Sustained training programs on hyperglycaemia control to ICU staff and the availability of a protocol on glycaemia control are highly required.

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Section: Discussionsupporting

confidence: 72%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Practice of Hyperglycaemia Control in Intensive Care Units of the Military Hospital, Sudan – Needs of a Protocol

El‐Raheem

Abdallah²,

Noma³

2020

Preprint

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show abstract

“…In our study, insulin infusion method was used for one patient and the NICE-SUGAR target was achieved [ 6 , 11 ]. While, mixed insulin method did not achieve the target glycaemic range as already reported by Marik P.E et al [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Practice of hyperglycaemia control in intensive care units of the Military Hospital, Sudan—Needs of a protocol

El‐Raheem

Abdallah²,

Noma

2022

PLoS ONE

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Hyperglycaemia is a major risk factor in critically ill patients leading to adverse outcomes and mortality in diabetic and non-diabetic patients. The target blood glucose remained controversial; this study aimed to contribute in assessing the practice of hyperglycaemia control in intensive care units of the Military Hospital. Furthermore, the study proposed a protocol for hyperglycaemia control based on findings. A hospital-based cross-sectional study assessed the awareness and practice towards hyperglycaemia management in a sample 83 healthcare staff selected through stratified random sampling technique. In addition, 55 patients were enrolled, through quota sampling, after excluding those with diabetic ketoacidosis, hyperosmolar-hyperglycaemic state and patients < 18 years. A self-administrated questionnaire enabled to collect data from health staff and patient data were extracted from the medical records. SPSS-23 was used to analyze the collected data. Chi-square and ANOVA tests assessed the association among variables, these tests were considered statistically significant when p ≤ 0.05. The training on hyperglycaemia control differed (p = 0.017) between doctors and nurses. The target glycaemic level (140–180 mg/dl) was known by 11.1% of the study participants. Neither the knowledge nor the practice of hyperglycaemia control methods differed among staff (p> 0.05). The use of sliding scale was prevalent (79.3%) across the ICUs (p = 0.002). 31.5% of the patients had received different glycaemic control methods, 11.8% were in the targeted blood glucose level. Sliding scale was the method used by doctors and nurses (71.4% and 81.6% respectively). Lack of awareness about hyperglycaemia management methods was prevalent among ICU healthcare staff. Use of obsolete methods was the common practice in the ICUS of the Military Hospital. Target blood glucose for patients were unmet. Development of a local protocol for glycaemic control in all ICUs is needed along with sustained training programs on hyperglycaemia control for ICU healthcare staff.

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“…Although there are many confounders, the authors concluded that utilizing basal insulin at 50% -59% of the 24-hour insulin need may be safe [38].…”

Section: Insulin Therapymentioning

confidence: 99%

Insulin Therapy for Hyperglycemia Management in Critically Ill Patients

Eastman¹,

Butler²,

Dicken³

et al. 2021

JDM

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Transition From Intravenous to Subcutaneous Insulin in Critically Ill Adults

Cited by 11 publications

References 17 publications

Practice of Hyperglycaemia Control in Intensive Care Units of the Military Hospital, Sudan – Needs of a Protocol

Practice of Hyperglycaemia Control in Intensive Care Units of the Military Hospital, Sudan – Needs of a Protocol

Practice of hyperglycaemia control in intensive care units of the Military Hospital, Sudan—Needs of a protocol

Insulin Therapy for Hyperglycemia Management in Critically Ill Patients

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