COMPARING INSULIN INFUSION PROTOCOLS FOR MANAGING SURGICAL STRESS HYPERGLYCEMIA
Main Article Content
Keywords
insulin infusion protocols, hyperglycemia, glucose, stress-induced
Abstract
Hyperglycemia management in surgical settings is crucial for optimizing patient outcomes, particularly in critically ill individuals. Insulin infusion protocols (IIPs) have evolved significantly, driven by the need to balance tight glycemic control with the risks of hypoglycemia. This article reviews the historical development, clinical outcomes, implementation strategies, and emerging trends of IIPs in surgical practice. Beginning with seminal studies demonstrating the benefits of intensive insulin therapy, the discussion spans challenges in protocol development, including patient variability and the role of advanced technologies like continuous glucose monitoring systems (CGMS). Clinical outcomes such as surgical site infections and cardiovascular events are assessed alongside strategies for protocol implementation and staff education. Future directions emphasize personalized dosing algorithms and evidence-based guidelines to enhance glycemic control while minimizing complications.
References
1. Umpierrez GE, Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978-982.
2. van den Berghe G, Wouters P, Weekers G, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
3. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet. 2009;373(9677):1798-1807.
4. Ishihara M, Kojima S, Sakamoto T, et al. Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era. Am Heart J. 2005;150(4):814-820.
5. Clement S, Braithwaite SS, Magee MF, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553-591.
6. Van den Berghe G, Schetz M, Vlasselaers D, et al. Clinical review: intensive insulin therapy in critically ill patients: NICE-SUGAR or Leuven blood glucose target? J Clin Endocrinol Metab. 2009;94(9):3163-3170.
7. Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353-369.
8. Lewis KS, Kane-Gill SL, Bobek MB, Dasta JF. Intensive insulin therapy for critically ill patients. Ann Pharmacother. 2004;38(7-8):1243-1251.
9. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21-33.
10. Krinsley JS. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc. 2004;79(8):992-1000.
11. Grey NJ, Perdrizet GA. Reduction of nosocomial infections in the surgical intensive-care unit by strict glycemic control. Endocr Pract. 2004;10(Suppl 2):46-52.
12. Malmberg K, Ryden L, Efendic S, et al. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995;26:57-65.
13. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354:449-461.
14. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21-33.
15. Reference not provided in the previous text.
16. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358:125-139.
17. Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:1283-1297.
18. Griesdale DE, de Souza RJ, van Dam RM, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ. 2009;180:821-827.
19. Finney SJ, Zekveld C, Elia A, Evans TW. Glucose control and mortality in critically ill patients. JAMA. 2003;290(15):2041-2047.
20. The DIGAMI 2 Study Group. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
21. The CREATE-ECLA Trial Group. Effect of glucose-insulin-potassium infusion on mortality in patients with acute myocardial infarction: results of the CREATE-ECLA randomized controlled trial. Lancet. 1995;346(8976):877-883.
22. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478.
23. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
24. American College of Endocrinology (ACE). ACE/ADA Task Force on Inpatient Diabetes. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-1131.
25. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
26. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478.
27. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125-139.
28. Mechanick JI, Handelsman Y, Bloomgarden ZT. Hypoglycemia in the intensive care unit. Curr Opin Clin Nutr Metab Care. 2007;10(2):193-196.
29. Davidson PC, Steed RD, Bode BW, et al. Use of a computerized intravenous insulin algorithm within a nurse-directed protocol for patients undergoing cardiovascular surgery. J Diabetes Sci Technol. 2008;2(3):369-375.
30. Dortch MJ, Mowery NT, Ozdas A, et al. A computerized insulin infusion titration protocol improves glucose control with less hypoglycemia compared to a manual titration protocol in a trauma intensive care unit. JPEN J Parenter Enteral Nutr. 2008;32(1):18-27.
31. Vogelzang M, Loef BG, Regtien JG, et al. Computer-assisted glucose control in critically ill patients. Intensive Care Med. 2008;34(8):1421-1427.
32. Davidson PC, Steed RD, Bode BW, et al. Glucommander: a computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation. Diabetes Care. 2005;28(10):2418-2423.
33. Goldberg PA, Siegel MD, Sherwin RS, et al. Implementation of a safe and effective insulin infusion protocol in a medical intensive care unit. Diabetes Care. 2004;27(3):461-467.
34. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21-33. doi:10.4158/EP.10.S2.21
35. Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978-982. doi:10.1210/jcem.87.3.8341
36. Vogelzang M, Zijlstra F, Nijsten MW. Design and implementation of GRIP: a computerized glucose control system at a surgical intensive care unit. BMC Med Inform Decis Mak. 2005;5:38. doi:10.1186/1472-6947-5-38
37. Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-1131. doi:10.2337/dc09-9029
38. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125-139. doi:10.1056/NEJMoa070716
39. Preiser JC, Devos P, Ruiz-Santana S, et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009;35(10):1738-1748. doi:10.1007/s00134-009-1585-2
40. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478. doi:10.4065/78.12.1471
41. American Diabetes Association. 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S211-S220. doi:10.2337/dc21-S015
42. Lacherade JC, Jacqueminet S, Preiser JC. An overview of hypoglycemia in the critically ill. J Diabetes Sci Technol. 2009;3(6):1242-1249. doi:10.1177/193229680900300602
43. Vriesendorp TM, DeVries JH, Holleman F, Dzoljic M, Hoekstra JB. The use of two continuous glucose sensors during and after surgery. Diabetes Technol Ther. 2005;7(3):315-322. doi:10.1089/dia.2005.7.315
44. Jones GC, Johnson KM. Cardiovascular system in the critically ill. Surgery (Oxford). 2017;35(11):601-606. doi:10.1016/j.mpsur.2017.08.004
45. Krinsley JS, Schultz MJ, Spronk PE, et al. Mild hypoglycemia is strongly associated with increased intensive care unit length of stay. Ann Intensive Care. 2011;1(1):49. doi:10.1186/2110-5820-1-49.
46. American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement 1), S1-S230. doi: 10.2337/dc22-S001
47. Umpierrez, G. E., & Hellman, R. (2012). Management of hyperglycemia in hospitalized patients in non-critical care setting: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 97(1), 16-38. doi: 10.1210/jc.2011-2098
48. Dhatariya, K. K., Nunney, I., Higgins, K., & Sampson, M. J. (2017). Iatrogenic hypoglycemia in patients with diabetes: A cause for concern. Practical Diabetes, 34(1), 21-26a. doi: 10.1002/pdi.2102
49. Moghissi, E. S., Korytkowski, M. T., DiNardo, M., Einhorn, D., Hellman, R., Hirsch, I. B., ... & Umpierrez, G. E. (2009). American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocrine Practice, 15(4), 353-369. doi: 10.4158/EP09102.RAR
50. rinsley, J. S., & Egi, M. (2010). Optimizing glucose control in critically ill patients. Critical Care, 14(2), 211. doi: 10.1186/cc8854
51. Lacherade, J. C., Jacqueminet, S., Preiser, J. C., & Ichai, C. (2010). Current aspects of stress hyperglycemia in ICU. Diabetes & Metabolism, 36(3), 207-218. doi: 10.1016/j.diabet.2010.03.001
52. Umpierrez, G. E., Smiley, D., Zisman, A., Prieto, L. M., Palacio, A., & Ceron, M. (2007). Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care, 30(9), 2181-2186. doi: 10.2337/dc07-0292
53. Dungan, K. M., Braithwaite, S. S., & Preiser, J. C. (2009). Stress hyperglycaemia. The Lancet, 373(9677), 1798-1807. doi: 10.1016/S0140-6736(09)60553-5
54. Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., ... & Bouillon, R. (2006). Intensive insulin therapy in the medical ICU. New England Journal of Medicine, 354(5), 449-461. doi: 10.1056/NEJMoa052521
55. Frisch, A., Chandra, P., Smiley, D., Peng, L., Rizzo, M., Gatcliffe, C., ... & Umpierrez, G. E. (2010). Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care, 33(8), 1783-1788. doi: 10.2337/dc10-0301
56. Golden, S. H., Peart-Vigilance, C., Kao, W. H., & Brancati, F. L. (2009). Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes. Diabetes Care, 32(5), 923-928. doi: 10.2337/dc08-2118
57. Bartnik, M., Malmberg, K., & Norhammar, A. (2009). Hyperglycaemia and cardiovascular disease. Journal of Internal Medicine, 266(6), 497-514. doi: 10.1111/j.1365-2796.2009.02139.x
58. Griesdale, D. E., de Souza, R. J., van Dam, R. M., Heyland, D. K., Cook, D. J., Malhotra, A., ... & Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis (2009). Intensive care unit patients. Annals of Internal Medicine, 150(11), 840-847. doi: 10.7326/0003-4819-150-11-200906020-00006
59. Badawi, O., & Breslow, M. J. (2012). Readmissions and death after ICU discharge: Development and validation of two predictive models. PLoS ONE, 7(11), e48758. doi: 10.1371/journal.pone.0048758
60. Heinemann L, Freckmann G. CGM Versus FGM; or, Continuous Glucose Monitoring Is Not Flash Glucose Monitoring. J Diabetes Sci Technol. 2015;9(5):947-950. doi:10.1177/1932296815584628.
61. Leelarathna L, Wilmot EG. Flash forward: a review of flash glucose monitoring. Diabet Med. 2018;35(4):472-482. doi:10.1111/dme.13665.
62. Bergenstal RM, Beck RW, Close KL, et al. Glucose management indicator (GMI): a new term for estimating A1C from continuous glucose monitoring. Diabetes Care. 2018;41(11):2275-2280. doi:10.2337/dc18-1581.
63. Bergenstal RM, Ahmann AJ, Bailey T, et al. Recommendations for standardizing glucose reporting and analysis to optimize clinical decision making in diabetes: the Ambulatory Glucose Profile (AGP). Diabetes Technol Ther. 2013;15(3):198-211. doi:10.1089/dia.2013.0051.
64. Jacobi J, Bircher N, Krinsley J, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med. 2012;40(12):3251-3276. doi:10.1097/CCM.0b013e3182653269.
65. Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(1):16-38. doi:10.1210/jc.2011-2098.
2. van den Berghe G, Wouters P, Weekers G, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
3. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet. 2009;373(9677):1798-1807.
4. Ishihara M, Kojima S, Sakamoto T, et al. Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era. Am Heart J. 2005;150(4):814-820.
5. Clement S, Braithwaite SS, Magee MF, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553-591.
6. Van den Berghe G, Schetz M, Vlasselaers D, et al. Clinical review: intensive insulin therapy in critically ill patients: NICE-SUGAR or Leuven blood glucose target? J Clin Endocrinol Metab. 2009;94(9):3163-3170.
7. Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353-369.
8. Lewis KS, Kane-Gill SL, Bobek MB, Dasta JF. Intensive insulin therapy for critically ill patients. Ann Pharmacother. 2004;38(7-8):1243-1251.
9. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21-33.
10. Krinsley JS. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc. 2004;79(8):992-1000.
11. Grey NJ, Perdrizet GA. Reduction of nosocomial infections in the surgical intensive-care unit by strict glycemic control. Endocr Pract. 2004;10(Suppl 2):46-52.
12. Malmberg K, Ryden L, Efendic S, et al. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995;26:57-65.
13. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354:449-461.
14. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21-33.
15. Reference not provided in the previous text.
16. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358:125-139.
17. Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:1283-1297.
18. Griesdale DE, de Souza RJ, van Dam RM, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ. 2009;180:821-827.
19. Finney SJ, Zekveld C, Elia A, Evans TW. Glucose control and mortality in critically ill patients. JAMA. 2003;290(15):2041-2047.
20. The DIGAMI 2 Study Group. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
21. The CREATE-ECLA Trial Group. Effect of glucose-insulin-potassium infusion on mortality in patients with acute myocardial infarction: results of the CREATE-ECLA randomized controlled trial. Lancet. 1995;346(8976):877-883.
22. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478.
23. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
24. American College of Endocrinology (ACE). ACE/ADA Task Force on Inpatient Diabetes. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-1131.
25. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
26. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478.
27. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125-139.
28. Mechanick JI, Handelsman Y, Bloomgarden ZT. Hypoglycemia in the intensive care unit. Curr Opin Clin Nutr Metab Care. 2007;10(2):193-196.
29. Davidson PC, Steed RD, Bode BW, et al. Use of a computerized intravenous insulin algorithm within a nurse-directed protocol for patients undergoing cardiovascular surgery. J Diabetes Sci Technol. 2008;2(3):369-375.
30. Dortch MJ, Mowery NT, Ozdas A, et al. A computerized insulin infusion titration protocol improves glucose control with less hypoglycemia compared to a manual titration protocol in a trauma intensive care unit. JPEN J Parenter Enteral Nutr. 2008;32(1):18-27.
31. Vogelzang M, Loef BG, Regtien JG, et al. Computer-assisted glucose control in critically ill patients. Intensive Care Med. 2008;34(8):1421-1427.
32. Davidson PC, Steed RD, Bode BW, et al. Glucommander: a computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation. Diabetes Care. 2005;28(10):2418-2423.
33. Goldberg PA, Siegel MD, Sherwin RS, et al. Implementation of a safe and effective insulin infusion protocol in a medical intensive care unit. Diabetes Care. 2004;27(3):461-467.
34. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21-33. doi:10.4158/EP.10.S2.21
35. Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978-982. doi:10.1210/jcem.87.3.8341
36. Vogelzang M, Zijlstra F, Nijsten MW. Design and implementation of GRIP: a computerized glucose control system at a surgical intensive care unit. BMC Med Inform Decis Mak. 2005;5:38. doi:10.1186/1472-6947-5-38
37. Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-1131. doi:10.2337/dc09-9029
38. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125-139. doi:10.1056/NEJMoa070716
39. Preiser JC, Devos P, Ruiz-Santana S, et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009;35(10):1738-1748. doi:10.1007/s00134-009-1585-2
40. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478. doi:10.4065/78.12.1471
41. American Diabetes Association. 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S211-S220. doi:10.2337/dc21-S015
42. Lacherade JC, Jacqueminet S, Preiser JC. An overview of hypoglycemia in the critically ill. J Diabetes Sci Technol. 2009;3(6):1242-1249. doi:10.1177/193229680900300602
43. Vriesendorp TM, DeVries JH, Holleman F, Dzoljic M, Hoekstra JB. The use of two continuous glucose sensors during and after surgery. Diabetes Technol Ther. 2005;7(3):315-322. doi:10.1089/dia.2005.7.315
44. Jones GC, Johnson KM. Cardiovascular system in the critically ill. Surgery (Oxford). 2017;35(11):601-606. doi:10.1016/j.mpsur.2017.08.004
45. Krinsley JS, Schultz MJ, Spronk PE, et al. Mild hypoglycemia is strongly associated with increased intensive care unit length of stay. Ann Intensive Care. 2011;1(1):49. doi:10.1186/2110-5820-1-49.
46. American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement 1), S1-S230. doi: 10.2337/dc22-S001
47. Umpierrez, G. E., & Hellman, R. (2012). Management of hyperglycemia in hospitalized patients in non-critical care setting: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 97(1), 16-38. doi: 10.1210/jc.2011-2098
48. Dhatariya, K. K., Nunney, I., Higgins, K., & Sampson, M. J. (2017). Iatrogenic hypoglycemia in patients with diabetes: A cause for concern. Practical Diabetes, 34(1), 21-26a. doi: 10.1002/pdi.2102
49. Moghissi, E. S., Korytkowski, M. T., DiNardo, M., Einhorn, D., Hellman, R., Hirsch, I. B., ... & Umpierrez, G. E. (2009). American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocrine Practice, 15(4), 353-369. doi: 10.4158/EP09102.RAR
50. rinsley, J. S., & Egi, M. (2010). Optimizing glucose control in critically ill patients. Critical Care, 14(2), 211. doi: 10.1186/cc8854
51. Lacherade, J. C., Jacqueminet, S., Preiser, J. C., & Ichai, C. (2010). Current aspects of stress hyperglycemia in ICU. Diabetes & Metabolism, 36(3), 207-218. doi: 10.1016/j.diabet.2010.03.001
52. Umpierrez, G. E., Smiley, D., Zisman, A., Prieto, L. M., Palacio, A., & Ceron, M. (2007). Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care, 30(9), 2181-2186. doi: 10.2337/dc07-0292
53. Dungan, K. M., Braithwaite, S. S., & Preiser, J. C. (2009). Stress hyperglycaemia. The Lancet, 373(9677), 1798-1807. doi: 10.1016/S0140-6736(09)60553-5
54. Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., ... & Bouillon, R. (2006). Intensive insulin therapy in the medical ICU. New England Journal of Medicine, 354(5), 449-461. doi: 10.1056/NEJMoa052521
55. Frisch, A., Chandra, P., Smiley, D., Peng, L., Rizzo, M., Gatcliffe, C., ... & Umpierrez, G. E. (2010). Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care, 33(8), 1783-1788. doi: 10.2337/dc10-0301
56. Golden, S. H., Peart-Vigilance, C., Kao, W. H., & Brancati, F. L. (2009). Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes. Diabetes Care, 32(5), 923-928. doi: 10.2337/dc08-2118
57. Bartnik, M., Malmberg, K., & Norhammar, A. (2009). Hyperglycaemia and cardiovascular disease. Journal of Internal Medicine, 266(6), 497-514. doi: 10.1111/j.1365-2796.2009.02139.x
58. Griesdale, D. E., de Souza, R. J., van Dam, R. M., Heyland, D. K., Cook, D. J., Malhotra, A., ... & Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis (2009). Intensive care unit patients. Annals of Internal Medicine, 150(11), 840-847. doi: 10.7326/0003-4819-150-11-200906020-00006
59. Badawi, O., & Breslow, M. J. (2012). Readmissions and death after ICU discharge: Development and validation of two predictive models. PLoS ONE, 7(11), e48758. doi: 10.1371/journal.pone.0048758
60. Heinemann L, Freckmann G. CGM Versus FGM; or, Continuous Glucose Monitoring Is Not Flash Glucose Monitoring. J Diabetes Sci Technol. 2015;9(5):947-950. doi:10.1177/1932296815584628.
61. Leelarathna L, Wilmot EG. Flash forward: a review of flash glucose monitoring. Diabet Med. 2018;35(4):472-482. doi:10.1111/dme.13665.
62. Bergenstal RM, Beck RW, Close KL, et al. Glucose management indicator (GMI): a new term for estimating A1C from continuous glucose monitoring. Diabetes Care. 2018;41(11):2275-2280. doi:10.2337/dc18-1581.
63. Bergenstal RM, Ahmann AJ, Bailey T, et al. Recommendations for standardizing glucose reporting and analysis to optimize clinical decision making in diabetes: the Ambulatory Glucose Profile (AGP). Diabetes Technol Ther. 2013;15(3):198-211. doi:10.1089/dia.2013.0051.
64. Jacobi J, Bircher N, Krinsley J, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med. 2012;40(12):3251-3276. doi:10.1097/CCM.0b013e3182653269.
65. Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(1):16-38. doi:10.1210/jc.2011-2098.
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Dr Gaurav Pali, Dr. Prem Chand Lamba, Ch. Lavanya, Dr. Divya Joshi, Dr. Ajai Kumar Pandey, & Bhagyalakshmi Purushothaman. (2024). COMPARING INSULIN INFUSION PROTOCOLS FOR MANAGING SURGICAL STRESS HYPERGLYCEMIA. Journal of Population Therapeutics and Clinical Pharmacology, 31(7), 1043–1053. https://doi.org/10.53555/jptcp.v31i7.7192
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Author Biographies
Dr Gaurav Pali
DNB PG RESIDENT 3RD YEAR GENERAL MEDICINE IG ESIC JHILMIL, DELHI
Dr. Prem Chand Lamba
Assistant Professor Mahatma Gandhi Medical College, Jaipur Physiology
Ch. Lavanya
Associate professor, GITAM INSTITUTE OF NURSING, GITAM UNIVERSITY
Dr. Divya Joshi
SR Mahatma Gandhi Medical College, Jaipur Physiology
Dr. Ajai Kumar Pandey
Associate Professor Department of Kayachikitsa (Internal Medicine), Faculty of Ayurveda Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India.
Bhagyalakshmi Purushothaman
Tutor Department of Biochemistry, Sri Venkateshwaraa medical college and hospitals, Redhills, Chennai.