Tag: insulin
Managing Blood Glucose Control in the ICU
Current evidence supports avoiding iatrogenic factors that aggravate hyperglycemia, such as early-PN and liberal corticosteroid use, and does not support TGC, except with accurate tools and protocols that prevent iatrogenic... read more
Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU
In critically ill patients who were not receiving early parenteral nutrition, tight glucose control did not affect the length of time that ICU care was needed or mortality. Of 9,230 patients who underwent randomization,... read more
High Dose Insulin and Euglycemia Therapy for Beta-adrenergic Receptor Treatment and Calcium Channel Antagonists Overdose
High dose insulin with dextrose supplementation is indicated for patients with calcium channel blocker and beta blocker overdose and signs of cardiac toxicity. Mechanisms are not completely elucidated, but mostly related... read more
The Truth About High-Dose Insulin
The agent involved when our poison center is consulted about cases of calcium channel blocker (CCB) poisoning these days is almost invariably amlodipine. Quite often, the clinical team will be reaching for high-dose insulin... read more
Higher CRP Rise Not Related To Cytokine Response
The higher C-reactive protein (CRP) rise with late parenteral nutrition (PN), explained by the early macronutrient deficits, did not relate to cytokine responses and thus did not reflect more systemic inflammation. Instead... read more
Addressing Hospital-Acquired Hypoglycemia
Findings suggest that ensuring a consistent 30-minute window between POC BG measurement and meal delivery enabled nursing staff to perform timely POC BG measurements and administer a more optimal mealtime insulin dose. Increasing... read more
Stress Hyperglycemia and Mortality in Subjects With Diabetes and Sepsis
Stress-induced hyperglycemia is a relevant prognostic factor also in the presence of diabetes. Mild-to-moderate stress hyperglycemia is considered a protective reaction to providing fuel for the immune system and brain at... read more
Pragmatic Approach to Inpatient Diabetes Management During COVID-19
The pandemic of COVID-19 has presented new challenges to hospital personnel providing care for infected patients with diabetes who represent more than 20% of critically ill patients in ICUs. Appropriate glycemic management... read more
Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery
A FF strategy was not associated with changes to early enteral nutrition delivery. Inflammation, insulin resistance, and morbidity were similar, but FF may modify the relationship between inflammation and adverse event. Multicenter... read more
Lower Glucose Targets Show Improved Mortality in Cardiac Patients
Tighter glucose control while minimizing the risk of severe hypoglycemia is associated with lower mortality among critically ill cardiac patents, new research suggests. Researchers reported in CHEST on the outcomes of... read more
Incidence of Hypoglycemia in Following Insulin‐based Acute Treatment of Hyperkalemia
Iatrogenic hypoglycemia, as a result of treatment for hyperkalemia, is a common occurrence. Hyperkalemia occurs disproportionately in patients with acute kidney injury or end‐stage renal disease, and these patients are... read more
Acute Hyperglycemic Emergencies
As diabetes prevalence increases in the US, critical care nurses need to be familiar with the acute hyperglycemic emergencies they may encounter in the ED or ICU. This article focuses on the diagnosis of, various treatments... read more
Hypertriglyceridemic pancreatitis: Can we defuse the bomb?
Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more
Electrophysiological Investigations of Peripheral Nerves and Muscles
Resting trans-membrane potential difference (Em) of skeletal muscle is correlated to the energy status of the organism: the more severe the illness, the lower the Em. In 1971, Cunningham demonstrated this association with... read more
What constitutes optimal glucose management in Critical Care?
Glycaemic Control in the EU. Following on from the poster we presented at the Intensive Care Society. We asked Sphere Medical's own Dr Gavin Troughton to present at our launch event. In the below video he goes into more... read more
Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis
Patients with sepsis and a pre-existing diagnosis of insulin-treated diabetes (ITD) may show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 hours than... read more
A comparison of two insulin infusion protocols in the ICU by continuous glucose monitoring
The Yale protocol provided better average glycemia, more time spent in normoglycemia, less time in hypoglycemia, and less glycemic variability than the Leuven protocol, but was not independently associated with strict glycemic... read more
Hyperglycaemia in Critically Ill Patients
There is an ongoing debate regarding the efficacy of glycaemic control in critically ill patients. Here we briefly highlight the key function of elevated glucose in critically ill patients, namely, to enable elevation of... read more
Anabolic and Anticatabolic Agents in Critical Care
Profound metabolic derangements occur in critically ill patients; this hypermetabolic response is a major contributor to adverse outcomes. Despite the pharmacological therapies currently available to counteract this devastating... read more
Better glycemic control with continuous glucose monitoring
This randomized clinical trial compares the effects of continuous glucose monitoring vs conventional treatment for glycemic control in adult patients with type 1 diabetes treated with multiple daily insulin injections.... read more
Disease Causation Index Established By New Mathematical Model
Patients with complex diseases have a higher risk of developing another. Multi-morbidity represents a huge problem in everyday clinical practice, because it makes it more difficult to provide successful treatment. By analysing... read more
