Archive of SID The efficacy of intensive glucose management on hospitalized critically ill patients associated mortality rate in intensive care unit

Background and Purpose of the study: Hyperglycemia and insulin resistance are common findings among critically ill patients. Intensive insulin therapy reduces morbidity and mortality in patients of surgical and medical intensive care units (ICUs), but its role in patients of general intensive care units still remains unknown. The present study was designed to determine the effect of intensive insulin therapy on ICU mortality. Methods: Adult patients admitted to general intensive care units in Valiy-e- Asr Hospital, who required intensive care for at least five days were considered for a prospective, randomized and control study. On admission, patients were randomly chosen either to normalize their blood glucose levels or to prepare them for conventional therapy. Results: Intensive insulin therapy reduced blood glucose levels of 129 patients but did not have any significant effect on reduction of mortality rate of hospitalized patients (30.6% in the conventional-treatment group vs. 38.8% in the intensive-treatment group, p > 0.05). However, the morbidity rate was significantly plummeted as a consequence of acceleration in the process of weaning of the patient from mechanical ventilation, and subsequently discharging from the ICU. The benefit of intensive insulin therapy was attributed to its effect on mortality among patients who remained in the intensive care unit for more than five days (78.9% conventionaltreatment group vs. 46.2% intensive-treatment group, p = 0.04). Conclusion: Intensive insulin therapy significantly reduced morbidity but not mortality among the patients in general intensive care units. The very possible risk of subsequent diseaseassociated and fatal complications was reduced in patients who were treated for five days or longer time. Further studies are required to confirm these preliminary results.