As suboptimal blood glucose control has a lasting harmful effect even if control improves later, intensive insulin therapy to minimise hyperglycaemia is now recommended for all patients with type 1 diabetes. The new rapid- and long-acting insulin analogues offer more physiological insulin profiles than traditional insulin preparations. Continuous insulin infusion ("pump therapy") may provide a ...

OBJECTIVES Maintenance of normoglycemia with insulin reduces mortality and morbidity of critically ill patients. Here we report the factors determining insulin requirements and the impact of insulin dose vs. blood glucose control on the observed outcome benefits. DESIGN A prospective, randomized, controlled trial. SETTING A 56-bed predominantly surgical intensive care unit in a tertiary tea...

Postprandial hyperglycemia in insulin-deficient, insulin-dependent diabetic subjects may result from impaired suppression of endogenous glucose production and/or abnormal disposition of meal-derived glucose. To investigate the relative contributions of these processes and to determine whether 2 wk of near normoglycemia achieved by using intensive insulin therapy could restore the pattern of glu...

Hyperglycemia is a major risk factor for increased morbidity and mortality in the intensive care unit. In two large randomized controlled single-center studies, the maintenance of strict normoglycemia with intensive insulin therapy has been shown to reduce morbidity and mortality. The benefits were more pronounced with at least a few days of treatment. Several implementation studies confirmed t...

microalbuminuria is thought to reflect the severity of inflammation-induced systemic vascular permeability. the present study investigated the effect of early administration of metformin or insulin on microalbuminuria in traumatized critically ill patients. between april 2006 and october 2007, thirty-one non-diabetics traumatized patients with systemic inflammatory response syndrome (sirs) and ...

Results: The benefit of intensive insulin care was from 8.0 percent with conventional treatment to 4.6 percent (P<0.04, with adjustment for sequential analyses). Intensive insulin therapy to maintain blood glucose at or below 110mg per deciliter reduced the morbidity and motility among critically ill patients in the surgical intensive care unit. Hyperglycemia was present in 38% of patient admit...