Curative effect of intensive insulin therapy in critical old patients with stress hyperglycemia

Abstract

Objective To observe the clinical curative effect of early intensive insulin therapy for critical old patients with stress hyperglycemia. Methods Fifty-six (> 60 years) patients in critical conditions with stress hyperglycemia were divided into two groups randomly, the intensive ins lin-therapy (IIT) group (n = 28) and traditional insulin-therapy (TIT) group (n = 28). The serum C-reactive protein (CRP) level, the time of the usage of insulin-infusion, the days in the ICU, the incidence of infection in hospital, mortality and the complications of hypoglycemia and hypokalemia were recorded. Results In IIT group, the serum CRP level, the time of usage of insulin, the days in the ICU, the incidence of infection in hospital and mortality were significandy lower than that in TIT group. (P < 0.05), but the wound healing rate was elevated obviously. As to complications, the incidence of hypoglycemia and hypokalemia was higher in IIT group than that in TIT group, even though there was no statistical significance on incidences of hypokalemia. Conclusions For critical old patients with stress hyperglycemia, early intensive insulin therapy can control blood glucose more effectively and promptly and improve the clinical curative effect. But the targeted nursing care for hypoglycemia and hypokalemia should be reinforced for the patients with intensive insulin-therapy. Key words: Hyperglycemia; Insulin; Therapy; Aged; Critical illness