Abstract

Background: Hyperglycemia with or without diabetes is associated with increased morbidity and mortality in critically ill patients. The management practices to control hyperglycemia vary widely and often do not conform to standard guidelines.

Aim and Objective: The aim of the study was to find out various pharmacological interventions used to manage hyperglycemia, frequency, and characteristics of drug-induced hypoglycemic episodes, and factors associated with BGLs at or above 180 mg/dL.

Material and Methods: This prospective observational study was conducted in a tertiary care hospital on 369 adult patients admitted in medical or surgical intensive care unit and suffering from hyperglycemia. The pharmacological interventions used to control hypoglycemia, characteristics of drug-induced hypoglycemic episodes, and factors associated with blood glucose level (BGL) at or above 180 mg/dL were evaluated.

Result: About 43% of patients received no pharmacological intervention, in 33% of patients basal bolus insulin was used while oral antidiabetic agents were used in 7.3% of patients. Blood glucose was maintained within a target range of 140–180 mg/dL on 45.6% patient-days. Basal bolus insulin was linked to hypoglycemia in 85.7% of hypoglycemic episodes. Previous history of diabetes, use of 0.45% dextrose normal saline, beta-blockers, and statins were associated with BGL above 180 mg/dL.

Conclusion: Management of hyperglycemia in ICU patients is less than optimal.

Key words: Blood Glucose Level; Intensive Care Unit; Basal Bolus Insulin; Sliding Scale Insulin