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Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis.
Endocr Pract. 2012 May-Jun; 18(3):394-8.EP

Abstract

OBJECTIVE

To investigate the effects of intravenous chromium on serum glucose and insulin infusion rates in hospitalized patients with severe insulin resistance.

METHODS

In this retrospective study, we reviewed hospital records from January 1, 2008, to December 1, 2008, to identify patients for whom intravenous chromium was ordered at our academic medical center. To be included, patients were required to demonstrate profound insulin resistance and uncontrolled hyperglycemia (defined as the inability to achieve a blood glucose value less than 200 mg/dL during the 12 hours before chromium was given despite administration of continuous insulin infusion at a rate of 20 or more units/h) and to have received a continuous infusion of chromium chloride at 20 mcg/h for 10 to 15 hours for a total dose of 200 to 240 mcg.

RESULTS

Fourteen patients met our inclusion criteria. Over the hour preceding intravenous chromium infusion, the mean ± standard deviation rate of insulin infusion was 31 ± 15 units/h, and blood glucose was 326 ± 86 mg/dL. Twelve hours after the initiation of chromium, these values were 16 ± 16 units/h and 162 ± 76 mg/dL, respectively (P = .011 for difference in mean insulin rate from baseline, P<.001 for difference in mean blood glucose from baseline) and 24 hours after, these values were 12 ± 15 units/h and 144 ± 48 mg/dL, respectively (P<.001 for both).

CONCLUSIONS

Intravenous chromium decreases insulin needs and improves glucose control at 12 and 24 hours compared with baseline values. Chromium appears to improve hyperglycemia and insulin resistance in acutely ill patients and represents a potential new therapy. Future prospective randomized controlled trials are needed to confirm these results.

Authors+Show Affiliations

Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota 55455, USA. drake120@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22297054

Citation

Drake, Tyler C., et al. "Chromium Infusion in Hospitalized Patients With Severe Insulin Resistance: a Retrospective Analysis." Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, vol. 18, no. 3, 2012, pp. 394-8.
Drake TC, Rudser KD, Seaquist ER, et al. Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis. Endocr Pract. 2012;18(3):394-8.
Drake, T. C., Rudser, K. D., Seaquist, E. R., & Saeed, A. (2012). Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 18(3), 394-8. https://doi.org/10.4158/EP11243.OR
Drake TC, et al. Chromium Infusion in Hospitalized Patients With Severe Insulin Resistance: a Retrospective Analysis. Endocr Pract. 2012;18(3):394-8. PubMed PMID: 22297054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis. AU - Drake,Tyler C, AU - Rudser,Kyle D, AU - Seaquist,Elizabeth R, AU - Saeed,Asad, PY - 2012/2/3/entrez PY - 2012/2/3/pubmed PY - 2012/9/15/medline SP - 394 EP - 8 JF - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists JO - Endocr Pract VL - 18 IS - 3 N2 - OBJECTIVE: To investigate the effects of intravenous chromium on serum glucose and insulin infusion rates in hospitalized patients with severe insulin resistance. METHODS: In this retrospective study, we reviewed hospital records from January 1, 2008, to December 1, 2008, to identify patients for whom intravenous chromium was ordered at our academic medical center. To be included, patients were required to demonstrate profound insulin resistance and uncontrolled hyperglycemia (defined as the inability to achieve a blood glucose value less than 200 mg/dL during the 12 hours before chromium was given despite administration of continuous insulin infusion at a rate of 20 or more units/h) and to have received a continuous infusion of chromium chloride at 20 mcg/h for 10 to 15 hours for a total dose of 200 to 240 mcg. RESULTS: Fourteen patients met our inclusion criteria. Over the hour preceding intravenous chromium infusion, the mean ± standard deviation rate of insulin infusion was 31 ± 15 units/h, and blood glucose was 326 ± 86 mg/dL. Twelve hours after the initiation of chromium, these values were 16 ± 16 units/h and 162 ± 76 mg/dL, respectively (P = .011 for difference in mean insulin rate from baseline, P<.001 for difference in mean blood glucose from baseline) and 24 hours after, these values were 12 ± 15 units/h and 144 ± 48 mg/dL, respectively (P<.001 for both). CONCLUSIONS: Intravenous chromium decreases insulin needs and improves glucose control at 12 and 24 hours compared with baseline values. Chromium appears to improve hyperglycemia and insulin resistance in acutely ill patients and represents a potential new therapy. Future prospective randomized controlled trials are needed to confirm these results. SN - 1934-2403 UR - https://www.unboundmedicine.com/medline/citation/22297054/Chromium_infusion_in_hospitalized_patients_with_severe_insulin_resistance:_a_retrospective_analysis_ L2 - http://journals.aace.com/doi/10.4158/EP11243.OR?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -