Transition From Intravenous to Subcutaneous Insulin in Critically Ill Adults

Journal of Diabetes Science and Technology
Meagan K DoolinAndrew C Fritschle-Hilliard

Abstract

Glycemic control decreases morbidity and mortality in critically ill patients. However, limited guidance exists regarding the transition from intravenous (IV) to subcutaneous insulin therapy. A validated protocol for transition is necessary since glycemic variability, hyperglycemia, and hypoglycemia adversely impact patient outcomes. The objective was to determine the safest and most effective method to transition critically ill adults from IV to subcutaneous insulin. This single-center, retrospective, observational study included adults admitted to the burn, medical, or surgical/trauma intensive care units from January 1, 2011, to September 30, 2014. A computer-based program provided a reflection of the patient's total daily IV insulin requirements. This information was then utilized to stratify patients into groups according to their initial dose of subcutaneous insulin as a percentage of the prior 24-hour IV requirements (group stratification: 0-49%, 50-59%, 60-69%, 70-79%, ≥80%). The primary endpoint was the percentage of blood glucose (BG) concentrations within target range (70-150 mg/dL) 48 hours following transition. One hundred patients with 1394 BG concentrations were included. The 50-59% group achieved the highest rat...Continue Reading

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Citations

Sep 10, 2021·International Journal of Clinical Pharmacy·Abdulrahman I AlshayaPaul M Szumita

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