Feasibility Study On A Reduction Procedure Of Intensive Insulin Therapy

Objectives: To investigate the feasibility on a reduction procedure of intensive insulin therapyBackgrounds: Intensive insulin therapy had been proved to be effective in reducing the morbidity and mortality in critically ill patients.In consideration of its complexity and the patients' life quality , a reduction procedure of intensive insulin theray was designed in the study.Methods: A prospective, randomized and controlled study.All adults who were admitted to HUAXI hospital ICU between May 2004 and October 2004 were selected and randomized into two groups:treatment group and control group.In treatment group, intravenous insulin was administed for only first 7 days to maintain normglycemia in ICU.After 7 days ,the administion of glycemia did not differ between two groups.In control group,glycemia was treated by the traditional therapy. The mortality of 30 days, the blood glucose level for first 14 days in ICU , the daily insulin dose, the length of ventilatory support and the length of stay in ICU were recorded.Base line was estimated by the APACHE II score and the blood glucose level for the first time.Result: At 6 months , with a total of 30 patients enrolled,the mortality in treatment group was reduced(31% vs 50%),although this difference was no statistical signifiant but a decreasing trend(P=0.0909).In treatment group ,blood glucose level was actually maintained at a mean value of 6.58 + 2.11 mmol/L in the first 7 days , and declined to a mean value 5.92+1.24 mmol/L in the second 7 days.Meanwhile, the mean daily insulin dose in the corresponding period was reduced. During the 14 days, blood glucose level and daily insulin dose all did not differ significantly in control groupConclusions: The reduction proceduce of intensive insulin therapy has it's feasibility, and need further research proved.