Subcutaneous versus intravenous insulin therapy for glucose control in non-diabetic trauma patients. A randomized controlled trial
Article first published online: 22 OCT 2012
© 2012 Blackwell Publishing Ltd
Journal of Clinical Pharmacy and Therapeutics
Volume 38, Issue 1, pages 24–30, February 2013
How to Cite
Aron, A., Wang, J., Collier, B., Ahmed, N. and Brateanu, A. (2013), Subcutaneous versus intravenous insulin therapy for glucose control in non-diabetic trauma patients. A randomized controlled trial. Journal of Clinical Pharmacy and Therapeutics, 38: 24–30. doi: 10.1111/jcpt.12012
- Issue published online: 2 JAN 2013
- Article first published online: 22 OCT 2012
- Received 19 June 2012, Accepted 18 September 2012
- randomized controlled;
What is known and Objective: Hyperglycaemia in trauma patients admitted to the intensive care unit (ICU) is associated with increased morbidity and mortality. Our pilot study is a prospective randomized controlled trial comparing the impact of two glucose control regimens on outcomes in non-diabetic trauma patients admitted with hyperglycaemia to the ICU.
Methods: Trauma patients with blood glucose levels (BGLs) ≥7·8 mm within the first 48 h of the hospital admission were randomized to receive intermittent SQ or continuous IV insulin to maintain BGLs between 4·4 and 6·1 mm. We excluded diabetics on the basis of history, or a glycosylated haemoglobin ≥6% on admission. We compared the effect of SQ vs. IV insulin therapy on the ICU length of stay (ILOS).
Results and Discussion: A total of 58 patients were included in the study. The SQ and IV groups were comparable in terms of age, gender, injury severity, revised trauma, Glasgow coma scores and type of trauma (blunt vs. penetrating). There was no significant difference between the two treatment groups in the ILOS (3 vs. 2 days, P = 0·084), hospital length of stay (8 vs. 6, P = 0·09), ventilator support days (6 vs. 3, P = 0·98), requirement for blood transfusion (P = 0·66), rates of infections (P = 0·70), acute kidney injury (P = 0·99) and mortality (P = 0·61).
What is new and Conclusion: There was no difference between SQ and IV insulin therapy in the ILOS in non-diabetic trauma patients.