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Table 2 Insulin usage, glucose control, and safety of an intensive insulin protocol stratified by study period

From: Intensive insulin therapy and mortality in critically ill patients

 

Period I

(n = 2,366)

1 Mar 01 to 28 Feb 02

Period II

(n = 3,322)

1 Mar 02 to 30 Jun 03

Period III

(n = 4,786)

1 Jul 03 to 28 Feb 05

P valuea

Patients receiving insulin infusion, n (%)

206 (8.71)

817 (24.59)

2,027 (42.51)

<0.01

Patients receiving subcutaneous insulin, n (%)

307 (14.21)

349 (13.93)

237 (8.65)c

<0.01

Patients receiving any insulin, n (%)

513 (21.68)

1,166 (35.10)b

2,264 (47.48)c

<0.01

Average daily dose of insulin, units/24 hours, mean ± SDd

72.4 (84.9)

55.7 (58.7)

47.5 (43.1)

<0.01

Central lab 6 a.m. blood glucose

n = 2,339

n = 3,278

n = 4,643

 

   Mean ± SD

144.0 ± 38.1

138.7 ± 34.4

129.3 ± 30.3

<0.01

   Median (IQR)

138 (120–160)

134 (117–153)

125 (112–140)

 

Average daily blood glucose, mean ± SD

146.6 ± 41.5

142.0 ± 37.4

132.6 ± 30.8

<0.01

Average daily blood glucose, median (IQR)

139 (121–161)

136 (120–156)

128 (115–143)

 

Average point-of-care blood glucose

n = 700

n = 1,407

n = 2,610

 

   Mean ± SD

167.4 ± 46.7

148.0 ± 36.8

131.6 ± 31.2

<0.01

Hypoglycemia <40 mg/dL, n (%)e

24 (1.01)

53 (1.60)

103 (2.15)c

<0.01

Hypoglycemia <65 mg/dL, n (%)e

115 (4.86)

351 (10.57)

810 (16.99)

<0.01

High-concentration glucose replacement, n (%)f

86 (3.63)

244 (7.34)

462 (9.69)

<0.01

Hyperglycemia >200 mg/dL, n (%)

330 (14.1)

367 (11.1)

339 (7.26)

<0.01

  1. aAnalysis of variance or chi-square comparing the three study periods; period I is used as reference. bP <0.05 compared with period I (Wald test). cP <0.01 compared with period I (Wald test). dPatients receiving insulin infusion only. eNumber of patients with at least one episode of hypoglycemia; blood glucose values include both point-of-care and central laboratory measurements. fHigh-concentration glucose indicates administration of 50 mL of dextrose 50% (25 g). IQR, interquartile range; SD, standard deviation.