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Updated: Jun 17, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Comparisons of different insulin infusion protocols: a review of recent literature
Armand Krikorian1, Faramarz Ismail-Beigi, Etie S Moghissi
1Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA. armand.krikorian@uhhospitals.org
Purpose Of Review:
To provide an update on the currently available insulin infusion protocols for treatment of hyperglycemia in critically ill patients and to discuss the major differences and similarities among them.
Recent Findings:
We identified a total of 26 protocols, 20 of which used manual blood-glucose calculations, and six that used computerized algorithms. The major differences and similarities among the insulin infusion protocols were in the following areas: patient characteristics, target glucose level, time to achieve target glucose level, incidence of hypoglycemia, rationale for adjusting the rates of insulin infusion, and methods of blood-glucose measurements. Several computerized protocols hold promise for safer achievement of glycemic targets.
Summary:
Insulin infusion is the most effective method for controlling hyperglycemia in critically ill patients. Clinicians should utilize a validated insulin infusion protocol that is well tolerated, and is most appropriate and practical for their institution based on the resources that are available.
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