Background: Intensive insulin protocols (IIPs) have been demonstrated to reduce morbidity and mortality in critically ill patients. Currently, there are no published studies evaluating glycemic control after discontinuation of an IIP.
Objective: The purpose of this study was to compare blood glucose (BG) control during an IIP and for 5 days following its discontinuation (follow-up period).
Methods: The study was a retrospective review of intensive care unit patients who received an IIP for >or=24 hours. Data were collected during the last 12 hours of the IIP and subsequent follow-up period.
Results: For all 65 included patients, the mean +/- standard deviation for BG on the IIP was 123 +/- 26 mg/dL versus 168 +/- 50 mg/dL following discontinuation of the IIP (P < 0.001). The median (interquartile range) insulin that was administered decreased from 40 (22-65) units on the IIP to 8 (0-18) units after the IIP was stopped (P < 0.001). The mean daily BG during the follow-up period was significantly higher than that during the IIP (P < 0.001). Additionally, an insulin requirement of >20 units during the last 12 hours of the IIP was identified as a risk factor for poor glycemic control during the follow-up period (odds ratio: 4.62; 95% confidence interval: 1.17-18.17).
Conclusions: This study demonstrates a significant increase in BG following discontinuation of an IIP. Higher insulin requirements during the last 12 hours of an IIP were identified as an independent risk factor for poor glycemic control following the IIP. A standardized insulin transition protocol may help better control BG after discontinuation of an IIP.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/jhm.393 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
"Now I can see it works!" Perspectives on Using a Nutrition-Focused Approach When Initiating Continuous Glucose Monitoring in People with Type 2 Diabetes: Qualitative Interview Study.
JMIR Diabetes
January 2025
Center for Evaluation and Survey Research, HealthPartners Institute, Bloomington, MN, United States.
Background: Food choices play a significant role in achieving glycemic goals and optimizing overall health for people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) can provide a comprehensive look at the impact of foods and other behaviors on glucose in real time and over the course of time. The impact of using a nutrition-focused approach (NFA) when initiating CGM in people with T2D is unknown.
View Article and Find Full Text PDFComparative efficacy and safety of sitagliptin or gliclazide combined with metformin in treatment-naive patients with type 2 diabetes: A single-center, prospective, randomized, controlled, noninferiority study with genetic polymorphism analysis.
Medicine (Baltimore)
January 2025
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Background: This study evaluates the efficacy and safety of sitagliptin versus gliclazide, combined with metformin, in treatment-naive patients with type 2 diabetes mellitus (T2DM) and glucotoxicity.
Methods: In this single-center, randomized, controlled noninferiority trial, 129 treatment-naive patients with T2DM with glucotoxicity (fasting plasma glucose [FPG] ≥ 200 mg/dL and glycated hemoglobin ≥ 9.0%) were randomized to receive sitagliptin plus metformin (n = 66) or gliclazide plus metformin (n = 63) for 12 weeks.
Automated insulin delivery in pregnant women with type 1 diabetes mellitus: a systematic review and meta-analysis.
Acta Diabetol
January 2025
1st Paediatric Department, School of Medicine, Faculty of Health Sciences, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Aims: To assess the efficacy and safety of automated insulin delivery (AID) systems compared to standard care in managing glycaemic control during pregnancy in women with Type 1 Diabetes Mellitus (T1DM).
Methods: We searched MEDLINE, Cochrane Library, registries and conference abstracts up to June 2024 for randomized controlled trials (RCTs) and observational studies comparing AID to standard care in pregnant women with T1DM. We conducted random effects meta-analyses for % of 24-h time in range of 63-140 mg/dL (TIR), time in hyperglycaemia (> 140 mg/dl and > 180 mg/dL), hypoglycaemia (< 63 mg/dl and < 54 mg/dL), total insulin dose (units/kg/day), glycemic variability (%), changes in HbA1c (%), maternal and fetal outcomes.
Controlled Nutrient Delivery to Pancreatic Islets Using Polydopamine-Coated Mesoporous Silica Nanoparticles.
Nano Lett
January 2025
Department of Radiology, Interventional Radiology Innovation at Stanford (IRIS), Stanford University School of Medicine, Palo Alto, California 94304, United States.
In this study, we designed a nanoscale platform for sustained amino acid delivery to support transplanted pancreatic islets. The platform features mesoporous silica nanoparticles (MSNPs) loaded with glutamine (G), an essential amino acid required for islet survival and function, and coated with polydopamine (PD). We investigated various PD concentrations (0.
View Article and Find Full Text PDFGut Microbiota and Diabetes: Pioneering New Treatment Frontiers.
Endocr Metab Immune Disord Drug Targets
January 2025
Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Lovely Professional University, Panjab, 144001, India.
Diabetes Mellitus (DM) is a complex metabolic disorder characterized by chronic hyperglycemia and poses significant global health challenges. Conventional treatments, such as insulin therapy and lifestyle modifications, have shown limited efficacy in addressing the multifactorial nature of DM. Emerging evidence suggests that gut microbiota, a diverse community of microorganisms critical for metabolism and immune function, plays a pivotal role in metabolic health.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!