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Updated: Feb 26, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Hyperglycemia in critical patients: Determinants of insulin dose choice
Aline Klitzke Paliosa1, Cassiano Teixeira2, Regis Goulart Rosa3
1Pharmacy Resident, Integrated Multiprofessional Health Residency (REMIS), Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA) and Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Objective::
To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia.
Method::
Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level. Patients with one or more episodes of hyperglycemia (blood glucose greater than 180 mg/dL) were included as a convenience sample, not consecutively. Those with continuous insulin prescription were excluded from analysis.
Results::
We included 64 records of hyperglycemia observed in 22 patients who had at least one episode of hyperglycemia. The median administered subcutaneous regular human insulin was 6 IU and among the factors evaluated only blood glucose levels were associated with the choice of insulin dose administered.
Conclusion::
Clinical characteristics such as diet, medications and diagnosis of diabetes mellitus are clearly ignored in the decision-making regarding insulin dose to be administered for glucose control in critically ill patients with hyperglycemia.
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