Cost considerations with tight glycemic control in the acute care setting

Hyperglycemia is associated with increased morbidity and mortality in critically ill patients. Clinical trial data has demonstrated that controlling hyperglycemia with insulin infusions guided by frequent blood glucose monitoring can reduce this morbidity and mortality. Pharmacoeconomic analyses of these studies have found that tight glycemic control in the critically ill patient is highly cost-effective. Given the relatively small cost of achieving tight glycemic control (about 200 dollars per patient), most economic analyses have demonstrated that tight glycemic control protocols are actually cost saving. Based on the outcomes of cardiac surgery and intensive care unit studies, the cost per life year gained resulting from the implementation of tight glycemic control protocols is less than 6000 dollars (highly cost-effective). Benefits of implementing tight glycemic control protocols in critical or intensive care units includes not only reductions in morbidity and mortality, but reductions in hospital costs.