Incretins in the ICU: is insulin on its way out?

Table 1 Summary of studies on glucagon-like peptide-1 in hospitalized patients

	Deane and colleagues [1]	Mussig and colleagues [14]	Sokos and colleagues [15]	Meier and colleagues [16]
Patient population	ICU, mechanically ventilated	Post CABG	Pre and post CABG	Post major surgery
Number of patients	7	20	20	8
Male/female	4/3	18/2	17/3	5/3
Diabetes mellitus	No	All	5/20	All
Nutrition	Enteral feeding	No parenteral feeding	Allowed to eat	Fasting
Intervention	GLP-1 at 1.2 pmol/kg/minute	GLP-1 at 3.6 pmol/kg/minute	GLP-1 at 1.5 pmol/kg/minute	GLP-1 at 1.2 pmol/kg/minute
Duration of intervention	4.5 hours	12 hours	12 hours before CABG to 48 hours after CABG	8 hours
Control group	Placebo (albumin)	Insulin	Placebo (saline)	Placebo
Results	Significantly decreased AUC for glucose	Glycemic control comparable with insulin-treated group	Significantly decreased AUC for glucose	Normoglycemia
Side effects	None	None	One episode of hypoglycemia	None

AUC, area under the curve; CABG, coronary artery bypass grafting; GLP-1, glucagon-like peptide-1; ICU, intensive care unit.

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