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Related Experiment Video

Updated: Jun 29, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Intensive insulin therapy in practice: can we do it?

Lesly A Dossett¹, Bryan Collier, Rafe Donahue

¹Division of Trauma & Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37212, USA. lesly.dosset@vanderbilt.edu

JPEN. Journal of Parenteral and Enteral Nutrition

|October 4, 2008

Summary

Adherence to intensive insulin therapy (IIT) protocols in the ICU is challenging. Late blood glucose (BG) measurements negatively impact glycemic control, increasing risks of hyperglycemia and hypoglycemia.

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Last Updated: Jun 29, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

Critical Care Medicine
Endocrinology
Clinical Practice

Background:

Intensive insulin therapy (IIT) is standard ICU care but difficult to implement precisely.
Quantifying adherence to IIT protocols and its impact on blood glucose (BG) control is crucial.

Purpose of the Study:

To quantify adherence to an IIT protocol in a clinical setting.
To describe the impact of adherence on overall BG control.

Main Methods:

Retrospective analysis of critically ill patients treated with IIT.
Evaluation of protocol adherence by assessing the timing of BG measurements (early, on time, late).
Outcome measures included mean BG, median BG, and proportion of values within the target range.

Main Results:

Analysis of 54,139 BG measurements in 1106 patients.
Overall mean BG was 116 mg/dL, with only 46% of values within the 80-110 mg/dL target range.
Late BG measurements (9%) were less likely to be within range (34% vs. 46%) and associated with severe hyperglycemia or hypoglycemia.

Conclusions:

Precise implementation of IIT is challenging in complex ICU environments.
Measurement timing significantly impacts BG control.
Late BG measurements increase the risk of both hyperglycemic and hypoglycemic episodes.