Pectively. Discussion Computerised decision-support and more intensive monitoring did not improve BG control or reduce

Pectively. Discussion Computerised decision-support and more intensive monitoring did not improve BG control or reduce the incidence of hypoglycaemia.P131 Glargine insulin: an alternative to regular insulin for glycemic control in critically ill patientsM Bhattacharyya, SK Todi, A MedChemExpress YKL-05-099 Majumdar AMRI Hospitals, Kolkata, India Critical Care 2007, 11(Suppl 2):P131 (doi: 10.1186/cc5291) Introduction The objective of this study was to determine the efficacy and safety of subcutaneous (s.c.) once-daily (OD) glargine insulin, a long-acting insulin, in comparison with a s.c. regular insulin, based on a protocolized sliding scale regimen for achieving glycemic control in patients admitted to the ICU. Methods One hundred patients admitted to the ICU with an admission capillary blood glucose (CBG) >150 mg/dl (8.3 mmol/l) were involved in this prospective, randomized study. Patients with age <18 years, pregnancy, shock, requiring continuous intravenous insulin infusion, renal failure were excluded. PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20799856 Patients were randomly assigned to receive either s.c. glargine insulin 10 U (CBG 9.9 mmol/l) or 18 U (CBG 10.1 mmol/l) s.c. OD (Group G, n = 50), or s.c. regular insulin based on a 6-hourly sliding scale (Group R, n = 50). CBGs were recorded at 6-hour intervals up to 96 hours or until ICU discharge, whichever was earlier. The target CBG in both groups was <150 mg/dl (8.3 mmol/l). Patients in group G received rescue doses of regular insulin, as required. Demographic characteristics, mean and median CBG, and episodes of hypoglycemia were studied. Results Demographic profiles were comparable between the two groups. There was no significant difference in mean CBG in both groups (Group G 152.1 mg/dl (8.4 mmol/l), Group R 149.9 mg/dl (8.3 mmol/l), P = 0.66). Median CBGs were comparable at 6hourly time points in both the groups except at 0 and 6 hours in the glargine arm (CBG at 0 and 6 hours, Group G 10.0 mmol/l andFigure 1 (abstract P131)P130 Evaluation of the clinical effectiveness of a computerised decision-supported intensive insulin therapy regimenR Shulman, N Shah, P Glynne, R Greene, SJ Finney University College Hospital, London, UK Critical Care 2007, 11(Suppl 2):P130 (doi: 10.1186/cc5290) Introduction It has been proposed that intensive insulin therapy (IIT) aiming for a blood glucose (BG) of 4.4?.1 mmol/l reduces mortality in critically ill patients when compared with conventional insulin therapy (CIT) targeting BG at 10.0?1.1 mmol/l. Difficulties with IIT include inadvertent hypoglycaemia and low efficacy at achieving the target BG. We proposed that computerised decision support may mitigate these problems. Objective To comprehensively describe BG and outcome from decision-supported IIT. Methods A clinical information system at each bedspace guided staff through the IIT algorithm. The time spent within glucose ranges was calculated assuming a linear trend between successive measurements. Results Patient characteristics are shown in Table 1. The IIT group had more frequent BG evaluation (7,007 over 8,944 patient-hours,Table 1 (abstract P130) IIT (n = 50) LOS, median (IQR) Survivors APACHE II, mean Medical Surgical 7 (3?1) 34 (64.2 ) 23.2 31 (62 ) 19 (38 ) CIT (n = 50) 6 (3?1) 24 (48.0 ) 25.4 35 (70 ) 15 (30 ) P value 0.05 0.07 0.17 0.53 0.Median capillary blood glucose (CBG) at different time points.SAvailable online http://ccforum.com/supplements/11/S9.9 mmol/l, Group R 9.4 mmol/l and 8.3 mmol/l, P = 0.04 and 0.02, respectively) (Figure 1). There were.