PURPOSE: The aim of this study is to compare the safety and efficacy of 2 different strategies for glycemic control in critically ill adult patients. MATERIALS AND METHODS: A total of 337 patients were randomly assigned to a carbohydrate-restrictive strategy (group 1) through glucose-free venous hydration, hypoglycidic nutritional formula, and subcutaneous insulin if blood glucose level was higher than 180 mg/dL or to strict normalization of blood glucose levels (80-120 mg/dL) with the use of insulin infusion (group 2). RESULTS: Patients in group 1 (n = 169) received 2 (0-6.5) units of regular insulin per day, whereas patients in group 2 (n = 168) received 52 (35-74.5) units per day (P < .001). The median blood glucose level was 144 mg/dL in group 1 and 133.6 mg/dL in group 2 (P = .003). Hypoglycemia occurred in 6 (3.5%) patients in group 1 and 27 (16%) in group 2 (P < .001) and was an independent risk factor for neurological dysfunction and mortality. CONCLUSIONS: A carbohydrate-restrictive strategy reduced significantly the incidence of hypoglycemia in critically ill patients compared to intensive insulin therapy. Mortality and morbidity were comparable between the 2 groups. Copyright 2010 Elsevier Inc. All rights reserved.
RCT Entities:
PURPOSE: The aim of this study is to compare the safety and efficacy of 2 different strategies for glycemic control in critically ill adult patients. MATERIALS AND METHODS: A total of 337 patients were randomly assigned to a carbohydrate-restrictive strategy (group 1) through glucose-free venous hydration, hypoglycidic nutritional formula, and subcutaneous insulin if blood glucose level was higher than 180 mg/dL or to strict normalization of blood glucose levels (80-120 mg/dL) with the use of insulin infusion (group 2). RESULTS:Patients in group 1 (n = 169) received 2 (0-6.5) units of regular insulin per day, whereas patients in group 2 (n = 168) received 52 (35-74.5) units per day (P < .001). The median blood glucose level was 144 mg/dL in group 1 and 133.6 mg/dL in group 2 (P = .003). Hypoglycemia occurred in 6 (3.5%) patients in group 1 and 27 (16%) in group 2 (P < .001) and was an independent risk factor for neurological dysfunction and mortality. CONCLUSIONS: A carbohydrate-restrictive strategy reduced significantly the incidence of hypoglycemia in critically illpatients compared to intensive insulin therapy. Mortality and morbidity were comparable between the 2 groups. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: José Raimundo Araújo de Azevedo; Renato Palácio de Azevedo; Lara Carneiro de Lucena; Nathalia de Nazaré Rabelo da Costa; Widlane Sousa da Silva Journal: Clinics (Sao Paulo) Date: 2010-06 Impact factor: 2.365
Authors: Yatin Mehta; Ambrish Mithal; Atul Kulkarni; B Ravinder Reddy; Jeetendra Sharma; Subhal Dixit; Kapil Zirpe; M N Sivakumar; Harita Bathina; Sanghamitra Chakravarti; Anshu Joshi; Sameer Rao Journal: Indian J Crit Care Med Date: 2019-12
Authors: Ra'eesa Doola; Alwyn S Todd; Josephine M Forbes; Adam M Deane; Jeffrey J Presneill; David J Sturgess Journal: JMIR Res Protoc Date: 2018-04-09