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Outcomes of Less Intensive Glycemic Target for a Subcutaneous Insulin Protocol in Hospitalized Patients.
Kaur, Gagandeep; Markley, Brandon; Schlauch, Karen; Izuora, Kenneth E.
Afiliação
  • Kaur G; Department of Internal Medicine (GK, BM, KEI), University of Nevada School of Medicine, Las Vegas, Nevada; Department of Pharmacy (BM), University Medical Center, Las Vegas, Nevada; and Department of Biochemistry/Molecular Biology (KS), Nevada Center for Bioinformatics, University of Nevada, Reno, Nevada.
Am J Med Sci ; 350(6): 442-6, 2015 Dec.
Article em En | MEDLINE | ID: mdl-26445303
BACKGROUND: This study looked at the effect of replacing an intensive subcutaneous insulin correction protocol (old subcutaneous insulin correction protocol [OP]) with a less intensive protocol (new subcutaneous insulin correction protocol [NP]) in a tertiary hospital with the hypothesis that using the NP will result in less hypoglycemia and improved hospital outcomes. METHODS: The charts for 200 hospitalized patients managed with the OP (glycemic target 90-116 mg/dL for intensive care and 90-130 mg/dL for nonintensive care patients) and 200 with the NP (glycemic target 150-200 mg/dL) were reviewed. Data were collected and analyzed using Fisher's exact test and Student's t test. The primary outcome was the difference in hypoglycemia rates between the 2 protocols. Hypothesis test P values of <0.05 were deemed significant. RESULTS: There was no statistically significant difference in age, sex, ethnicity, body mass index, level of hospital care or use of scheduled insulin for the 2 groups (P > 0.05 for all). Average blood glucose values were 160.45 and 169.98 mg/dL for the OP and NP, respectively (P = 0.063). There were 14 readings ≤ 40 mg/dL in the OP compared with 6 in the NP (P = 0.046). With the OP, 27 patients required dextrose treatment compared to 11 with the NP (P = 0.0097). The average length of hospitalization was longer for the NP compared with the OP (13.16 versus 6.56 days, P = 0.00085). CONCLUSIONS: A less intensive subcutaneous insulin correction protocol in hospitalized patients resulted in similar glucose values with less severe hypoglycemia. However, it was associated with longer length of hospitalization.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hiperglicemia / Hipoglicemia / Hipoglicemiantes / Insulina Tipo de estudo: Guideline / Observational_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hiperglicemia / Hipoglicemia / Hipoglicemiantes / Insulina Tipo de estudo: Guideline / Observational_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2015 Tipo de documento: Article