Evaluation of blood glucose values in critically ill patients before and after implementation of an intensive insulin infusion protocol.

This retrospective study evaluated the effect of an intensive insulin infusion protocol on blood glucose values in five intensive care units at Baylor University Medical Center. The protocol involved an equation in which the hourly blood glucose value and an adjusted multiplier were used to determine the insulin infusion rate. The default target blood glucose range was 90 to 120 mg/dL. Results showed that blood glucose values taken by diabetic fingerstick were significantly better in March 2006, after initiation of the protocol, than in March 2005, before use of the protocol, for the percentage of patients both with a blood glucose value >150 mg/dL (P < 0.001) and with a blood glucose value >120 mg/dL (P < 0.001). The percentage of patients with a blood glucose value ≤80 mg/dL was not significantly different between the two time periods (P > 0.10). The increased number of diabetic fingerstick values within a desired range was achieved without a significantly higher number of blood glucose values ≤80 mg/dL. It can be theorized that wide use of the protocol was at least partly responsible for the significant change in blood glucose values.