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Insulin usage, glucose control, and safety of an intensive insulin protocol stratified by study period |
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| Period I (n = 2,366) 1 Mar 01 to 28 Feb 02 |
Period II (n = 3,322) 1 Mar 02 to 30 Jun 03 |
Period III (n = 4,786) 1 Jul 03 to 28 Feb 05 |
P valuea |
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| Patients receiving insulin infusion, n (%) |
206 (8.71) |
817 (24.59) |
2,027 (42.51) |
<0.01 |
| Patients receiving subcutaneous insulin, n (%) |
307 (14.21) |
349 (13.93) |
237 (8.65)c |
<0.01 |
| Patients receiving any insulin, n (%) |
513 (21.68) |
1,166 (35.10)b |
2,264 (47.48)c |
<0.01 |
| Average daily dose of insulin, units/24 hours, mean ± SDd |
72.4 (84.9) |
55.7 (58.7) |
47.5 (43.1) |
<0.01 |
| Central lab 6 a.m. blood glucose |
n = 2,339 |
n = 3,278 |
n = 4,643 |
|
| Mean ± SD |
144.0 ± 38.1 |
138.7 ± 34.4 |
129.3 ± 30.3 |
<0.01 |
| Median (IQR) |
138 (120–160) |
134 (117–153) |
125 (112–140) |
|
| Average daily blood glucose, mean ± SD |
146.6 ± 41.5 |
142.0 ± 37.4 |
132.6 ± 30.8 |
<0.01 |
| Average daily blood glucose, median (IQR) |
139 (121–161) |
136 (120–156) |
128 (115–143) |
|
| Average point-of-care blood glucose |
n = 700 |
n = 1,407 |
n = 2,610 |
|
| Mean ± SD |
167.4 ± 46.7 |
148.0 ± 36.8 |
131.6 ± 31.2 |
<0.01 |
| Hypoglycemia <40 mg/dL, n (%)e |
24 (1.01) |
53 (1.60) |
103 (2.15)c |
<0.01 |
| Hypoglycemia <65 mg/dL, n (%)e |
115 (4.86) |
351 (10.57) |
810 (16.99) |
<0.01 |
| High-concentration glucose replacement, n (%)f |
86 (3.63) |
244 (7.34) |
462 (9.69) |
<0.01 |
| Hyperglycemia >200 mg/dL, n (%) |
330 (14.1) |
367 (11.1) |
339 (7.26) |
<0.01 |
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aAnalysis of variance or chi-square comparing the three study periods; period I is used as reference. bP <0.05 compared with period I (Wald test). cP <0.01 compared with period I (Wald test). dPatients receiving insulin infusion only. eNumber of patients with at least one episode of hypoglycemia; blood glucose values include both point-of-care and central laboratory measurements. fHigh-concentration glucose indicates administration of 50 mL of dextrose 50% (25 g). IQR, interquartile range; SD, standard deviation. | ||||
Treggiari et al. Critical Care 2008 12:R29 doi:10.1186/cc6807 |
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