Effectiveness of insulin solution: a comparison between different times for maintaining the solution

Area of Science:

• Critical Care Medicine
• Endocrinology
• Clinical Pharmacy

Background:

• Hyperglycemia is common in critically ill patients and linked to poor outcomes.
• Intensive blood glucose control with intravenous insulin is increasingly used.
• Evidence on the long-term efficacy and safety of insulin solutions is limited.

Purpose of the Study:

• To compare blood glucose levels between two insulin infusion protocols with different solution replacement times (6 vs. 24 hours) in critically ill patients.
• To assess the rate of hypoglycemia associated with each protocol.
• To evaluate the feasibility of 24-hour insulin solution replacement.

Main Methods:

• Retrospective chart review of 80 critically ill patients receiving insulin therapy for over 24 hours.
• Patients were divided into two groups: 40 with insulin solution replaced every 6 hours and 40 with replacement every 24 hours.
• Comparison of capillary blood glucose levels and incidence of hypoglycemia between the groups.

Main Results:

• No significant differences in blood glucose levels were observed between the 6-hour and 24-hour insulin solution replacement groups.
• Three mild hypoglycemia cases occurred in the 6-hour replacement group.
• No hypoglycemia was reported in the 24-hour replacement group.

Conclusions:

• Replacing insulin solutions every 24 hours is a feasible strategy in critically ill patients.
• The 24-hour replacement protocol demonstrated a potentially lower risk of hypoglycemia.
• Further research is needed to evaluate longer infusion times and potential hypoglycemic events.