Application of a glycaemic control optimization programme in patients with stress hyperglycaemia

Area of Science:

• Endocrinology
• Surgical Patient Management
• Critical Care Medicine

Background:

• Stress-induced hyperglycaemia (SHG) affects up to 75% of critically ill patients, increasing complication risks.
• Conventional intensive insulin therapy (CIIT) for SHG is associated with hypoglycemia and glucose variability.

Purpose of the Study:

• To evaluate the clinical efficacy of a blood glycaemic control optimization programme (BGCOP) for SHG in patients undergoing hepatobiliary or pancreatic surgery.
• To compare BGCOP with CIIT in terms of glycemic control and patient outcomes.

Main Methods:

• A randomized, controlled, prospective clinical study involving 86 patients with postoperative SHG.
• Patients were assigned to either CIIT or BGCOP, with a target blood glucose range of 7.8–10.0 mmol/L.
• Outcomes measured included time to target glycemic range, adverse events, and complication rates.

Main Results:

• BGCOP significantly accelerated achievement of the target blood glucose range compared to CIIT (p = 0.000).
• The BGCOP group exhibited significantly lower high glycaemic index (p = 0.000), incidence of hypoglycemia (p = 0.011), and adverse events.
• Infections, including abdominal (p = 0.026), incision (p = 0.044), and lung (p = 0.047), were significantly reduced with BGCOP.

Conclusions:

• BGCOP offers more effective blood sugar control than CIIT for patients with SHG following hepatobiliary or pancreatic surgery.
• This study provides a valuable approach for managing SHG in this patient population.