Related Experiment Video
Updated: Jun 11, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Ex vivo changes in blood glucose levels seldom change blood glucose control algorithm recommendations
L De Groene1, R E Harmsen, J M Binnekade
1Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Background:
Hyperglycemia and glycemic variabilities are associated with adverse outcomes in critically ill patients. Blood glucose control with insulin mandates an adequate and precise assessment of blood glucose levels. Blood glucose levels, however, can change ex vivo after sampling. The aim of this study was to determine whether this phenomenon affects the practice of blood glucose control.
Methods:
We performed an observational study in a mixed medical-surgical intensive care unit (ICU). ICU nurses were the primary healthcare workers involved in the practice of blood glucose control, and they used an insulin-titration method and blood-sampling algorithm aimed at maintaining blood glucose levels between 5 to 8 mmol/L.
Results:
Blood glucose levels were measured directly after sampling, as well as after 30 and 60 minutes using the same samples. Blood glucose control algorithm recommendations were scored for each measurement. We collected 450 blood samples from 74 patients (median of 3 [2-8] samples per patient). The mean ex vivo changes in the blood glucose level were rather small (-0.1±1.6 mmol/L (range -1.4 to 0.7) and -0.2±1.6 mmol/L (range -1.3 to 0.5) at 30 and 60 minutes after sampling, respectively; P<0.05). An ex-vivo change in the blood glucose level hardly ever resulted in a change in algorithm recommendation (4% and 6% at 30 and 60 minutes after sampling, respectively). In most cases the algorithm advised a lower insulin infusion speed.
Conclusion:
Ex vivo changes in blood glucose levels, although statistically significant, seem clinically irrelevant.
More Related Videos
08:01A Method for Manipulating Blood Glucose and Measuring Resulting Changes in Cognitive Accessibility of Target Stimuli
Published on: August 12, 2016
08:13Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test (OGTT) and Insulin Tolerance Test (ITT)
Published on: January 7, 2018
Related Concept Videos
Hormones Regulating Blood Glucose
In addition to accelerating glucose uptake and utilization, insulin has...
Hypoglycemia and Glucagon
Glucose Homeostasis: Regulation of Blood Glucose
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Hyperglycemia
Hypoglycemia
Diabetes Mellitus: Type 2 and Gestational