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Related Experiment Videos

Inpatient insulin therapy.

Susan Shapiro Braithwaite1

  • 1Division of Endocrinology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27599-7172, USA. sbraithw@med.unc.edu

Current Opinion in Endocrinology, Diabetes, and Obesity
|March 5, 2008
PubMed
Summary
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Intensive insulin therapy can improve patient outcomes by controlling blood glucose levels. New strategies reduce hypoglycemia and improve glycemic control, highlighting the need to achieve target blood glucose levels in hospitals.

Area of Science:

  • Endocrinology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Intravenous insulin infusion targeting blood glucose 80-110 mg/dl reduced mortality in a surgical intensive care unit.
  • Subsequent research has not defined specific glycemic targets for all inpatient settings.
  • Hospital outcomes are strongly linked to hyperglycemia.

Purpose of the Study:

  • To review recent literature on glycemic control in hospital settings.
  • To evaluate the effectiveness of different insulin administration strategies.
  • To determine optimal glycemic targets for improved patient outcomes.

Main Methods:

  • Review of recent observational and clinical literature.
  • Analysis of evidence for hypoglycemia as a mortality predictor.

Related Experiment Videos

  • Comparison of computerized vs. manual insulin algorithms.
  • Evaluation of subcutaneous insulin analog therapy vs. sliding scale insulin.
  • Assessment of diabetes patient self-management feasibility.

    • Main Results:

    • Hypoglycemia is an independent predictor of mortality in medical intensive care units.
    • Computerized intravenous insulin algorithms outperform manual ones.
    • Basal prandial correction subcutaneous insulin analog therapy is acceptable for cardiothoracic surgery patients.
    • Sliding scale insulin is inferior to basal prandial correction therapy.
    • Diabetes patient self-management is feasible in hospitals.

    Conclusions:

    • Improved insulin administration strategies reduce hypoglycemia and glycemic variability.
    • Achieving glycemic targets is crucial for optimizing patient outcomes.
    • Further research and clinical practice should focus on effective glycemic management strategies.