Differences in hospital glycemic control and insulin requirements in patients recovering from critical illness and those without prior critical illness

April D Miller¹, Leslie M Phillips², Richard M Schulz¹, P Brandon Bookstaver¹, Celeste N Rudisill^1
1Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy – University of South Carolina Campus, Columbia, SC, USA; ²Palmetto Health Richland, At the time of writing, Dr Phillips was a PharmD candidate at the University of South Carolina, SC, USA

Introduction: Hospital patients recovering from critical illness on general floors often receive insulin therapy based on protocols designed for patients admitted directly to general floors. The objective of this study is to compare glycemic control and insulin dosing in patients recovering from critical illness and those without prior critical illness.
Methods: Medical record review of blood glucose measurements and insulin dosing in 25 patients under general ward care while transitioning from the intensive care unit (transition group) and 25 patients admitted directly to the floor (direct floor group).
Results: Average blood glucose did not differ significantly between groups (transition group 9.49 mmol/L, direct floor group 9.6 mmol/L; P = 0.83). Significant differences in insulin requirements were observed between groups with average daily doses of 55.9 units in patients transitioning from the intensive care unit (ICU) versus 25.6 units in the direct floor group (P = 0.004).
Conclusions: Patients recovering from critical illness required significantly larger doses of insulin than those patients admitted directly to the floor. Managing insulin therapy in patients transitioning from the ICU may require greater insulin doses.

Keywords: hyperglycemia, glycemic control, insulin, critical illness