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Published on: June 11, 2012

Insulin-based regimens decrease mortality rates in critically ill patients: a systematic review

Jane Langley1, Gary Adams

  • 1Intensive Care, Lincoln County Hospital, Greetwell Road, Lincoln, Lincolnshire, LN2 5QY, UK.

Diabetes/Metabolism Research and Reviews
|November 8, 2006
PubMed
Abstract

Insights

Glucose-insulin-potassium (GIK) and insulin-based therapies show promise in reducing organ damage and mortality for critically ill hyperglycaemic patients after acute myocardial infarction (AMI). Tight glycaemic control is key to improving patient outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Critical Care Medicine

Background:

  • Hyperglycaemia is common in critically ill patients, particularly those with acute myocardial infarction (AMI).
  • Elevated blood glucose levels are associated with increased morbidity and mortality in these patients.
  • The optimal management of hyperglycaemia in intensive care settings remains an area of active research.

Purpose of the Study:

  • To evaluate the efficacy of glucose-insulin-potassium (GIK), insulin and glucose, or insulin alone in limiting organ damage post-AMI.
  • To assess the impact of these insulin-based regimens on mortality and morbidity in critically ill hyperglycaemic patients.
  • To determine if tight glycaemic control improves outcomes in intensive care.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs).
  • Included RCTs focused on insulin-based regimens for critically ill patients.
  • Studies were screened for relevance and inclusion criteria.

Main Results:

  • Six of ten studies on GIK reported reduced mortality and enhanced myocardial performance.
  • One study demonstrated that tight glycaemic control with insulin reduced intensive care morbidity and mortality.
  • A single study on insulin/glucose therapy indicated a one-year post-MI mortality reduction.

Conclusions:

  • Evidence supports the benefit of normoglycaemia and insulin-based regimens in critically ill patients.
  • These treatments are effective in limiting organ damage and reducing morbidity and mortality.
  • Insulin-based therapies are crucial for intensive care management of hyperglycaemic patients post-AMI.

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