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Assessment of quality of glycemic control in intensive care patients treated with an insulin infusion at a teaching hospital.
Can J Diabetes. 2014 Apr; 38(2):139-43.CJ

Abstract

OBJECTIVE

To describe the quality of glycemic control in patients in intensive care units (ICUs) treated with an intravenous (IV) insulin infusion at a teaching hospital.

METHOD

This retrospective study included patients admitted to the ICU and treated with an IV insulin infusion for at least 12 h between August 1 and November 30, 2011. Medical charts were reviewed. The primary quality indicator for glycemic control was the mean percent of blood glucose values per patient in the 6.1 to 8 mmol/L target range.

RESULTS

A total of 351 patients were included; 61.5% of subjects had no known diabetes. Admissions were mainly for surgery (61.3%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16.8±7.3. The mean percent of blood glucose values per patient in the 6.1 to 8 mmol/L range was 35% for all subjects and 26.2% for patients with diabetes. If a target of 6.1 to 10 mmol/L was considered, those values became 63% and 54.6%. At least 1 episode of hyperglycemia (>10 mmol/L), hypoglycemia (<4 mmol/L) or severe hypoglycemia (<2.2 mmol/L) was documented in 68%, 9% and 1% of subjects, respectively. Glycemic variability (SD) was 1.9 mmol/L, and the median hyperglycemic index was 0.77 (interquartile [IQ]: 0.24 to 1.63).

CONCLUSION

The quality of glycemic control in patients in the ICU at our hospital needs to be improved. A new computerized IV insulin protocol is currently being tested.

Authors+Show Affiliations

Département de Pharmacie, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada. Electronic address: lyne.gauthier.chum@ssss.gouv.qc.ca.Département de Pharmacie, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.Pharmacy Department, McGill University Health Centre, Montreal, Quebec, Canada.Département de Pharmacie, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.Département de Pharmacie, Centre hospitalier de l'Université de Sherbrooke, Sherbrooke, Quebec; and Centre de recherche clinique Etienne-Le Bel, Sherbrooke and Faculté de Pharmacie, Université de Montréal, Montreal, Quebec, Canada.Service d'Endocrinologie, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24690509

Citation

Gauthier, Lyne, et al. "Assessment of Quality of Glycemic Control in Intensive Care Patients Treated With an Insulin Infusion at a Teaching Hospital." Canadian Journal of Diabetes, vol. 38, no. 2, 2014, pp. 139-43.
Gauthier L, Ferguson J, Dubé AI, et al. Assessment of quality of glycemic control in intensive care patients treated with an insulin infusion at a teaching hospital. Can J Diabetes. 2014;38(2):139-43.
Gauthier, L., Ferguson, J., Dubé, A. I., Nguyen, P. V., Beauchesne, M. F., & Boutin, J. M. (2014). Assessment of quality of glycemic control in intensive care patients treated with an insulin infusion at a teaching hospital. Canadian Journal of Diabetes, 38(2), 139-43. https://doi.org/10.1016/j.jcjd.2014.01.012
Gauthier L, et al. Assessment of Quality of Glycemic Control in Intensive Care Patients Treated With an Insulin Infusion at a Teaching Hospital. Can J Diabetes. 2014;38(2):139-43. PubMed PMID: 24690509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of quality of glycemic control in intensive care patients treated with an insulin infusion at a teaching hospital. AU - Gauthier,Lyne, AU - Ferguson,Jessica, AU - Dubé,Anne-Isabelle, AU - Nguyen,Patrick Viet-Quoc, AU - Beauchesne,Marie-France, AU - Boutin,Jean-Marie, PY - 2013/12/03/received PY - 2014/01/22/revised PY - 2014/01/26/accepted PY - 2014/4/3/entrez PY - 2014/4/3/pubmed PY - 2015/2/24/medline KW - critical care KW - glycemic control KW - insuline intraveineuse KW - intravenous insulin KW - maîtrise glycémique KW - soins critiques SP - 139 EP - 43 JF - Canadian journal of diabetes JO - Can J Diabetes VL - 38 IS - 2 N2 - OBJECTIVE: To describe the quality of glycemic control in patients in intensive care units (ICUs) treated with an intravenous (IV) insulin infusion at a teaching hospital. METHOD: This retrospective study included patients admitted to the ICU and treated with an IV insulin infusion for at least 12 h between August 1 and November 30, 2011. Medical charts were reviewed. The primary quality indicator for glycemic control was the mean percent of blood glucose values per patient in the 6.1 to 8 mmol/L target range. RESULTS: A total of 351 patients were included; 61.5% of subjects had no known diabetes. Admissions were mainly for surgery (61.3%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16.8±7.3. The mean percent of blood glucose values per patient in the 6.1 to 8 mmol/L range was 35% for all subjects and 26.2% for patients with diabetes. If a target of 6.1 to 10 mmol/L was considered, those values became 63% and 54.6%. At least 1 episode of hyperglycemia (>10 mmol/L), hypoglycemia (<4 mmol/L) or severe hypoglycemia (<2.2 mmol/L) was documented in 68%, 9% and 1% of subjects, respectively. Glycemic variability (SD) was 1.9 mmol/L, and the median hyperglycemic index was 0.77 (interquartile [IQ]: 0.24 to 1.63). CONCLUSION: The quality of glycemic control in patients in the ICU at our hospital needs to be improved. A new computerized IV insulin protocol is currently being tested. SN - 2352-3840 UR - https://www.unboundmedicine.com/medline/citation/24690509/Assessment_of_quality_of_glycemic_control_in_intensive_care_patients_treated_with_an_insulin_infusion_at_a_teaching_hospital_ DB - PRIME DP - Unbound Medicine ER -