PMID- 38084454
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 58
IP  - 3
DP  - 2024 Mar
TI  - Safety and Effectiveness of a Standardized Intravenous Insulin Infusion Order Set 
      for Managing Uncontrolled Hyperglycemia Outside the Intensive Care Unit.
PG  - 241-247
LID - 10.1177/10600280231178876 [doi]
AB  - BACKGROUND: Few studies have evaluated the administration of intravenous (IV) 
      insulin infusions for uncontrolled hyperglycemia in non-intensive care unit (ICU) 
      patients, and there is inadequate data to guide how to appropriately administer 
      IV insulin infusions to this patient population. OBJECTIVE: Determine the 
      effectiveness and safety of our institution's non-critical care IV insulin 
      infusion order set. METHODS: This retrospective study was conducted at 2 
      institutions within a health care system. The primary outcome was the number of 
      individuals who achieved a glucose level </=180 mg/dL. For those meeting this 
      endpoint, the time to achieving this outcome and the percentage of glucose checks 
      within the goal range were determined. The primary safety endpoint was the number 
      of individuals who experienced hypoglycemia (glucose level <70 mg/dL). Patients 
      were included if they were >/=18 years of age and received the non-critical care IV 
      insulin infusion order set outside of the ICU. RESULTS: Twenty-one (84%) patients 
      achieved a glucose level </=180 mg/dL. The median (inter-quartile range [IQR]) time 
      to achieving the primary outcome was 5.7 h (3.9-8.3). In patients who achieved 
      the primary outcome, 41.8% of the glucose readings obtained after achieving this 
      outcome were within goal range. Two (8%) patients experienced hypoglycemia. Both 
      of these events occurred within 8 hours of therapy initiation and neither patient 
      received prior doses of subcutaneous insulin. Of the 4 patients who did not 
      achieve a glucose level </=180 mg/dL, 2 received high-dose corticosteroids, and 3 
      achieved a glucose level between 181 and 200 mg/dL. CONCLUSION AND RELEVANCE: Our 
      findings support the safe administration of IV insulin infusions to non-ICU 
      patients when targeting a glucose range of 140 to 180 mg/dL and limiting the 
      infusion duration.
FAU - Ibarra, Francisco Jr
AU  - Ibarra F Jr
AUID- ORCID: 0000-0003-0070-4203
AD  - Department of Pharmacy Services, Community Regional Medical Center, Fresno, CA, 
      USA.
AD  - College of Osteopathic Medicine, California Health Sciences University (CHSU), 
      Clovis, CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20230626
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Insulin)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Blood Glucose)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Humans
MH  - Insulin/adverse effects
MH  - Hypoglycemic Agents/therapeutic use
MH  - Retrospective Studies
MH  - Blood Glucose
MH  - *Hyperglycemia/drug therapy/chemically induced
MH  - *Hypoglycemia/chemically induced/drug therapy
MH  - Infusions, Intravenous
MH  - Glucose/therapeutic use
MH  - Intensive Care Units
OTO - NOTNLM
OT  - hyperglycemia
OT  - hypoglycemia
OT  - insulin
OT  - insulin infusions
OT  - non-critical care
COIS- Declaration of Conflicting InterestsThe author declared no potential conflicts of 
      interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/12/12 06:42
MHDA- 2024/02/12 15:43
CRDT- 2023/12/12 04:15
PHST- 2024/02/12 15:43 [medline]
PHST- 2023/12/12 06:42 [pubmed]
PHST- 2023/12/12 04:15 [entrez]
AID - 10.1177/10600280231178876 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2024 Mar;58(3):241-247. doi: 10.1177/10600280231178876. Epub 
      2023 Jun 26.