ArticleDiabetes technology & therapeutics2016
Evaluation of a Nurse-Managed Insulin Infusion Protocol.
Article in Diabetes technology & therapeutics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Enteral nutrition-related hyperglycemia in critical illness: cascade conceptual model and implications for precision nursing-a systematic review.Frontiers in nutrition · 2026Pooled it
- Peri-Liver Transplant Hyperglycemia: Mechanisms, Associated Factors, Consequences, and Management - A Systematic Review.Endocrinology, diabetes & metabolism · 2025Pooled it
- Nurse-led insulin protocol efficacy for control of hyperglycemia in critically Ill patients.BMC nursing · 2025Article
- Optimal Blood Glucose Monitoring Interval for Insulin Infusion in Critically Ill Non-Cardiothoracic Patients: A Pilot Study.Acta bio-medica : Atenei Parmensis · 2021Article
- Prospective evaluation of a dynamic insulin infusion algorithm for non critically-ill diabetic patients: A before-after study.PloS one · 2019Article
- Hypoglycemia Prevention by Algorithm Design During Intravenous Insulin Infusion.Current diabetes reports · 2018Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe purpose of this study was to evaluate the performance of an insulin infusion protocol targeting a blood glucose (BG) level of 140-180 mg/dL and to characterize protocol adherence. MATERIALS AND
methodsThis was a retrospective observational cohort study including patients for whom the protocol was ordered from January 2012 to May 2013. Performance metrics were assessed in all patients and in patients with an initial BG level of ≥200 mg/dL. Protocol adherence was assessed in a random subset of 50 patients without hypoglycemia and in all hypoglycemic patients.
resultsIn patients with an initial BG level of ≥200 mg/dL, the mean time to goal was 7.1 h. The rate of decline of BG level in the first 6 h was 16.4 mg/dL/h. Mean BG level was 167 mg/dL, with 43.9% of BG values within goal and 80.3% between 80 and 199 mg/dL. The rate of hypoglycemic events was 0.14 per 100 h. The mean protocol violation rate was higher in patients with hypoglycemia compared with those without (39.8 vs. 23.5 per 100 h, P = 0.002), and 60.7% of hypoglycemic events were attributable to protocol violations. The protocol violation rate (42.8 vs. 17.6 per 100 h; P < 0.001) and the odds of hypoglycemia (odds ratio = 5.2; 95% confidence interval, 1.6, 16.5) were higher in the cardiac surgery patients compared with other patients.
conclusionsThis protocol provides adequate BG control within the clinically acceptable range of 80-199 mg/dL but not within the narrower range of 140-180 mg/dL, with a low incidence of hypoglycemia. Risk factors for hypoglycemia and barriers to protocol adherence in the cardiac surgery population should be elucidated.
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Registered trials
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