Intensive insulin therapy may be harmful to the critically ill

Feb 29, 2008

Doubt has been cast over the current practice of administering intensive insulin therapy to all critically ill patients, according to a study published this week in the open access journal Critical Care. In certain groups of patients it could even be harmful.

This therapy is used widely in hospitals around the world, yet only one randomised, controlled trial showing unequivocal benefit has been published – and this trial focused mainly on patients who had undergone cardiac surgery. So, a team from Harborview Medical Center and the University of Washington, Seattle, set out to explore the relationship between intensive insulin therapy and hospital mortality in a mixed population of critically ill patients.

The researchers examined the outcomes of all (10,456) patients admitted to the seven intensive care units (ICUs) of Harborview Medical Center, the only Level 1 trauma center in a 5 state area of the northwest USA, before and after the introduction of intensive insulin protocols. The study period (March 2001 to February 2005) was split into three consecutive sections: Period I (no specific glycemic control protocol), Period II (target glucose 80–130mg/dL) and Period III (target glucose 80–110mg/dL). The study population included a mix of trauma, surgical, neurosurgical and medical ICU patients.

They found that a policy of intensive insulin therapy was not associated with a decrease in hospital mortality. While the proportion of patients receiving insulin infusions increased from 9% in Period I to 42% in Period III, patients in Period III tended towards higher hospital mortality than those in Period I. Hospital mortality was increased in patients with an ICU stay of three days or less.

The authors suggest that further study is necessary before intensive insulin therapy is implemented widely in critically ill patients.

They write: “We observed that intensive insulin therapy in a mixed cohort of critically ill patients was not associated with a reduction in hospital mortality, and was associated with increased ICU and hospital mortality in some subgroups. “These results, combined with data from the most recently concluded randomised trials, suggest that broad implementation of intensive insulin therapy may be premature, and that additional randomised trials in diverse groups of critically ill patients are necessary.”

Source: BioMed Central

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

add to favorites email to friend print save as pdf

Related Stories

Security experts sound medical device malware alarm

Oct 19, 2012

(Phys.org)—Speakers at a government gathering revealed more reasons for nervous patients to get out their worry beads over future hospital stays. Besides staph infections, wrong-side surgeries and inaccurate ...

Cell memory mechanism discovered

Aug 15, 2013

The cells in our bodies can divide as often as once every 24 hours, creating a new, identical copy. DNA binding proteins called transcription factors are required for maintaining cell identity. They ensure that daughter cells ...

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 0

More news stories

Filipino tests negative for Middle East virus

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

Study says we're over the hill at 24

(Medical Xpress)—It's a hard pill to swallow, but if you're over 24 years of age you've already reached your peak in terms of your cognitive motor performance, according to a new Simon Fraser University study.

NASA's space station Robonaut finally getting legs

Robonaut, the first out-of-this-world humanoid, is finally getting its space legs. For three years, Robonaut has had to manage from the waist up. This new pair of legs means the experimental robot—now stuck ...

Ex-Apple chief plans mobile phone for India

Former Apple chief executive John Sculley, whose marketing skills helped bring the personal computer to desktops worldwide, says he plans to launch a mobile phone in India to exploit its still largely untapped ...

Egypt archaeologists find ancient writer's tomb

Egypt's minister of antiquities says a team of Spanish archaeologists has discovered two tombs in the southern part of the country, one of them belonging to a writer and containing a trove of artifacts including reed pens ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.