Table 1 Summary of studies included in the present evaluation

[1]

765 Thoracosurgical ICU patients

4.4–6.1

Start at BG >6.1 mmol/l. Insulin ± 0.1–2 IU/hour depending on last two BG values. Glucose infusion or feeding

ICU based ABL700^® bloodgas/BG analyzer. Arterial blood samples

1–4 hours

5.1% of patients <2.2

Mean morning BG 5.7 ± 1.1

[4] (2004)

27 Mixed ICU patients

4–7

Bath IIP: insulin ± 0.5–4 IU/hour, depending on last two BG values

Accu Check^® Advantage 2. Mostly arterial samples

1–2 hours

Three BG values <2.2

Median BG 6.6

[2] (2004)

800 Mixed ICU patients

<7.7

Insulin sc. If two BG values >11.1 mmol/l: insulin iv, sliding scale. Glucose infusion/feeding

Finger stick samples or plasma BG (Vitros^® lab analyzer)

Every 3 hours if sc, hourly if iv

0.34% of patients <2.2

Mean BG 7.2 70% of BG <7.7

[5] (2001)

20 Critically ill diabetic patients

6.7

Insulin iv between -1.5 and +1.5 IU/hours depending on last two BG values. Glucose-potassium infusions

OneTouch^® II. Capillary samples

4 hours

No BG <2.5

Mean BG 7.8 ± 0.2

[6] (2004)

118 Cardiothoracic ICU patients

5.5–7.7

Yale IIP. Insulin ± 0.5–10 IU, depending on last two BG values and infusion rate

OneTouch^® Surestep Flex

1 hour

0.2% of BG <3.3

73% between 4.4 and 7.7

[7] (2004)

52 Medical ICU patients

5.5–7.7

Yale IIP. Insulin ± 0.5–10 IU, depending on last two BG values and infusion rate

OneTouch^® Surestep Flex

1–4 hours

0.3% of BG <3.3

66% between 4.4 and 7.7

[3] (2004)

50 Mixed ICU patients

4.5–6.1

Insulin ± 0.5–2 IU/hour, depending on last two BG values. Dextrose infusion or feeding

Accu Check^® Inform. Capillary samples

1–2 hours

4% of patients <2.2

11.5 ± 3.7 hours/day between 4.5 and 6.1

[8] (2004)

168 Cardiothoracic ICU patients

4.4–8.3

Insulin 1–16 IU/hour + bolus, sliding scale, depending on last BG value

Accu Check^® Inform. Venous samples

1–4 hours

7.1% of BG <2.2

61% of BG between 4.4 and 8.3

[9] (2003)

17 Diabetic patients, acute medical diseases

6–7

GIK + bolus, insulin 1–4 IU/h, dynamic scale, depending on last BG value

Hemocue^® meter. Capillary samples

1 hour

Four times

Mean BG 10.1

[10] (2002)

37 Postsurgical NIDDM patients

19 patients sc, 18 patients iv, sliding scale, 5% glucose infusion

Glucometer^®. Capillary samples

4 hours

5.6% of patients in iv group

sc mean: 7.2 ± 1.2 iv mean: 7.3± 1.1

[11] (2004)

72 Cardiothoracic diabetic patients

6.9–11.1

GIK protocol. Continuous GIK infusion + insulin bolus if BG >15 mmol/l

?

1 hour

Mean BG 7.7 ± 0.2

[31] (1996)

60 Surgical NIDDM patients

3.3–11.1

Insulin bolus if BG >11.1 mmol/l. Group 1: saline. Group 2: glucose-insulin. Group 3: bolus every 2 hours

Capillary samples

15 min

No

Mean BG <9 within all groups

[12] (2002)

29 Diabetic patients, cardiac surgery, 5 days

6.7–11.1

Start if BG >7.8 mol/l. Sliding scale

Venous and capillary samples

Six measurements per day

0.2% of BG <3.8

Mean BG 9.5

[13] (1997)

595 Diabetic patients, cardiac surgery

<11.1 l

Portland protocol: insulin depending on last two BG values and insulin infusion rate

Glucometer

1–2 hourly

Mean BG 9.7

[14] (1987)

24 Diabetic patients after surgery

6.7–10

Insulin ± 0.5 IU/hour depending on BG. Bolus if BG >13.3 mol/l. 5% dextrose infusion

Accu Check + strips

2 hourly

1.4% of measurements

Mean BG between 6.7 and 10

[15] (1988)

30 Diabetic patients, perioperative

5–10

Group 1: iv, every 4 hours ± 0.5 IU/hour. Group 2: sc, every 4 hours ± 2 IU/4 hours. Glucose-potassium infusion

Glucometer

Hourly during surgery, 4 hourly after surgery

0.6% of measurements <2.8 in iv group

67% of iv group between 5.0 and 10; 40% in sc group

[17] (2002)

188 Patients, during cardiac surgery

4.4–6.6

Start (2 IU/hour) with BG >6.6 mmol/l. Double infusion rate until BG <6.6 mol/l.

?

20 min

12% of patients with BG <3.8

In 23% of patients BG <8.3

[18] (1994)

77 Diabetic patients, surgery

6.7–10

Insulin ± 0.5–1.0 U/hr depending on BG

Reflolux S (+strips) and Glucose hexokinase (lab)

4 hourly, hourly during surgery

Two patients

62% of patients BG between 3.5 and 15.0

[19] (2000)

24 Type 2 diabetic patients, acute myocardial infarction

8.3–11.0

Insulin ± 1–2 IU/h, depending on BG range.

Venous samples. Automatic analyzer (lab)

30 min to 2 hours

Mean BG 6.9 ± 0.8

[20] (2002)

25 Diabetic patients, acute coronary syndromes

6.6–8.2

Insulin change by -1 to +3 IU/hour, depending on BG

Beckman^® glucose analyzer II

1–3 hourly

Four patients with mild hypoglycaemia

Mean 7.2 ± 1.7

[21] (1999)

25 Patients, acute stroke (during 24 hours)

4–7

GIK: 500 ml glucose 10% + 16 U insulin + 20 mmol KCl; 100 ml/hour. ± 4 U insulin/infusate, depending on BG

BM Glycemic strips

2 hourly

One patient

Mean BG of 68% of patients <7

[22] (1992)

29 Diabetic patients, acute myocardial infarction

4–8, to reach within 4 hours

Sliding scale, more insulin with left ventricular failure and bodyweight >120 % of ideal

Capillary samples

1–4 hourly

1.2% of BG <3

Mean BG 8.2 ± 1.3

[23] (1994)

158 Diabetic patients, acute myocardial infarction

7–10

>15 mmol/l; bolus iv. Insulin ± 0.5–1 IU/hour depending on BG. Glucose infusion

Venous samples. Reflolux II

1–2 hourly

17.7% of patients with BG <3.0 mmol/l

Mean BG 9.2 ± 2.9 after 24 hours

[24] (1991)

35 Diabetic patients, acute myocardial infarction

4–8

Sliding scale. Dextrose 5% infusion

Glucometer II^®. Capillary samples

2–4 hourly

Mean BG 10.3 ± 2.1