Continuous Glucose Monitoring for Hyperglycemia in Critically Ill Patients: A Randomized Controlled Trial.

Background: Continuous glucose monitors (CGMs) could potentially improve management of hyperglycemia compared with standard point-of-care glucose monitoring for critically ill patients. However, there is limited evidence to support routine use of CGMs in the ICU.

Research Question: In critically ill patients with hyperglycemia, do CGMs improve time within target glucose range compared with standard of care?

Study Design And Methods: This was an investigator-initiated, single-center, parallel-group, open-label, randomized controlled trial.

Risk Factors for Hypoglycemia During Treatment of Hyperglycemic Crises.

Objective: Diabetic ketoacidosis and hyperosmolar hyperglycemic state are life-threatening hyperglycemic crises often requiring intensive care unit (ICU) management. Treatment includes intravenous (IV) insulin with a transition to subcutaneous (SC) insulin upon resolution. Hypoglycemia is a common complication associated with treatment of hyperglycemic crises, but risk factors have not been well established.

Intravenous Insulin Infusion Protocol Compared With Subcutaneous Insulin for the Management of Hyperglycemia in Critically Ill Adults.

The use of an intravenous insulin infusion protocol (IIP) is recommended for management of hyperglycemia in the intensive care unit (ICU); however, limited evidence of comparison has been made with subcutaneous (SC) insulin regimens. This study aims to evaluate the safety and effectiveness of an IIP compared with SC insulin regimens in an ICU patient sample since the implementation of an IIP using a computerized clinical-decision support tool. This investigation was a retrospective cohort study of patients who were treated for hyperglycemia while admitted to any of the ICUs at a Veterans Affairs Medical Center.

Integration of Around-the-Clock Clinical Pharmacy Specialists Into the Critical Care Team Can Increase Safety of Hyperglycemic Crisis Management.

"Quality Improvement Success Stories" are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc., and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions.

A Bedside Computerized Decision-Support Tool for Intravenous Insulin Infusion Management in Critically Ill Patients.

Intravenous (IV) insulin infusions using a validated protocol are the recommended method for blood glucose control in critically ill patients. Computerized decision-support tools improve quality over manual paper-based protocols. However, nonproprietary computerized tools targeting the recommended blood glucose range of 140-180 mg/dL are not readily available.