Beneficial effect of glucose-insulin- potassium infusion in noncritically ill patients has to be proven – reply

Authors


Dr Mats Bonnier, The Lundberg Laboratory for Diabetes Research, Sahlgrenska University, S-413 45 Göteborg, Sweden (fax: +46 31 41 05 73; e-mail: mats.bonnier@medic.gu.se).

Dear Sir,

We thank Dr van der Hosts and colleagues for their interest to discuss our study and agree with their concerns about the need of more studies to prove the benefits of intensified insulin therapy in this diabetic group.

Earlier studies with glucose-insulin-potassium (GIK) infusion have been amongst diabetics with severe illness and probably suffered from severe insulin resistance [1–3]. These patients in this study were both type 1 and type 2 diabetics and the indications for the infusion were all from blood glucose fluctuation in ‘healthy’ insulin sensitive type 1 diabetics to severe insulin resistance amongst infectious diabetics.

Hypoglycaemia is common in and probably the biggest limiting factor to improve diabetes control amongst type 1 diabetics [4]. All this mild hypoglycaemia in this study was amongst type 1 diabetic patients and two of the hypoglycaemia episodes were in the same person.

The daily insulin demand was between 28 and 122 IU per day. Comparison and mean blood glucose values were calculated from measurements five times per day. The aim with this study was to validate and prove that this infusion was safe enough to handle at a normal internal medicine ward and without increasing the personal staff. Our hope is that this GIK-infusion algorithm could be a useful tool for future studies to prove the benefits of intensified insulin therapy even for this group of diabetics.

Conflict of interest statement

No conflict of interest was declared.

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