Effect of different blood glucose target levels on the incidence of hypoglycemia during insulin therapy in the intensive care unit (在重症监护病房中使用胰岛素治疗后不同的血糖目标水平对低血糖发生率的影响)

Abstract

Prior to 2003, the target blood glucose level at our institute was <200 mg/dL. This target was reassessed in 2004 and again in 2006 based on reports showing decreased mortality in patients with target glucose levels between 80 and 110 mg/dL and results from subsequent randomized controlled trials. The aim of the present study was to determine the incidence of hypoglycemia due to IIT. The primary endpoint of the study was the incidence of hypoglycemia, with secondary outcomes of morbidity and mortality in three different periods. A total of 2038 patients admitted to the intensive care unit (ICU) were divided into three groups with different target blood glucose levels: Group H, <200 mg/dL; Group M, <150 mg/dL; and Group L, <120 mg/dL. The incidence of hypoglycemia and patient outcomes in the three groups were compared. The incidence of serious hypoglycemia (<40 mg/dL) in Groups H, M and L was 3.5%, 4.0%, and 5.4%, respectively; the incidence of moderate hypoglycemia (<60 mg/dL) was 9.4%, 11.7%, and 21.0% (P < 0.01), respectively. There were no significant differences among the groups in terms of days connected to the ventilator, length of ICU stay and ICU mortalities. The incidence of moderate hypoglycemia (<60 mg/dL) was significantly increased during the period when the target blood glucose level was <120 mg/dL. Changes in target blood glucose levels did not affect patient mortality.