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Updated: Aug 6, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
A Retrospective Cohort Analysis of Two Computerized Insulin Infusion Protocols
Benjamin Lalani1,2, Kevin Gosselin3,4, Ruth Penno5
1Johns Hopkins University, Baltimore, MD, USA.
The Lalani Insulin Infusion Protocol (LIIP) offers faster euglycemia achievement compared to Glucommander, with similar safety profiles for hypoglycemia. This novel computerized insulin infusion protocol (CIIP) demonstrates improved efficacy in managing blood glucose levels.
Area of Science:
- Endocrinology
- Medical Informatics
- Clinical Pharmacy
Background:
- Computerized insulin infusion protocols (CIIPs) are crucial for managing blood glucose levels in various patient populations.
- Established protocols like Glucommander provide a benchmark for evaluating new systems.
- Optimizing CIIPs can lead to improved patient outcomes and reduced healthcare burdens.
Purpose of the Study:
- To compare the safety and efficacy of the Lalani Insulin Infusion Protocol (LIIP), a novel CIIP, against the established Glucommander protocol.
- To assess the time to euglycemia and the incidence of hypoglycemia and hyperglycemia with both protocols.
- To evaluate CIIP performance in challenging patient subgroups.
Main Methods:
- A 10-month retrospective analysis of 778 patients using LIIP was conducted.
- Data were compared with 4700 patients who previously used Glucommander at the same hospitals.
- Primary endpoints included time to euglycemia and time spent in hyperglycemia and hypoglycemia.
Main Results:
- LIIP demonstrated a significantly faster time to euglycemia (191 vs. 222 minutes, P < .001) compared to Glucommander.
- Both protocols showed similar, minimal time in hypoglycemia (2.79 vs. 2.76 minutes, P = .50).
- These findings were consistent across various patient subgroups, including those with DKA/HHS, COVID-19, on steroids, with renal insufficiency, and sepsis.
Conclusions:
- The Lalani Insulin Infusion Protocol (LIIP) is a safe and effective CIIP for intravenous insulin management.
- LIIP significantly reduces the time to achieve euglycemia without increasing hypoglycemia.
- Factors contributing to LIIP's success include improved workflow, ease of use, EHR compatibility, and its adaptive algorithm.
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