Delay in blood glucose monitoring during an insulin infusion protocol is associated with increased risk of hypoglycemia in intensive care units

Rajesh Garg, Amy Jarry, Merri Pendergrass

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

BACKGROUND: Hypoglycemia during insulin infusion therapy is a major problem. We investigated whether a delay in blood glucose (BG) monitoring during an insulin infusion protocol (IIP) in the intensive care unit (ICU) is associated with hypoglycemia. METHODS: Data were collected for 50 consecutive patients treated with Brigham and Women's Hospital's IIP. Point-of-care BG values were obtained from the bedside paper flow sheets and the exact times of individual measurements were ascertained from an internet-based glucose meter download program. Data were carefully studied for protocol time violations, defined as a delay of >10 minutes after the recommended time for BG measurement. RESULTS: A total of 2309 BG values were evaluated for time violation. A total of 1474 (63.9%) measurements had been obtained at the recommended time or earlier; 835 (36.1%) measurements had been obtained >10 minutes after the recommended time for measurement. There were a significantly higher proportion of BG values <80 mg/dL following the time violation as compared to no time violation (17.8% versus 11.6%; P < 0.001). CONCLUSION: We conclude that the risk of hypoglycemia during insulin infusion therapy is higher after a delay in BG measurement.

Original languageEnglish (US)
Pages (from-to)E5-E7
JournalJournal of Hospital Medicine
Volume4
Issue number6
DOIs
StatePublished - Jul 2009
Externally publishedYes

Keywords

  • Hypoglycemia
  • ICU
  • Insulin infusion

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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