No Benefit of Intensive Insulin Therapy in Hyperglycemia Patients
(HealthDay News) – Intensive insulin therapy (IIT) to treat hyperglycemia in hospitalized patients does not have any benefits and may cause harm, according to guidelines published online May 23 in the American Journal of Medical Quality.
Amir Qaseem, MD, PhD, MHA, from the American College of Physicians in Philadelphia, and colleagues reviewed the current evidence regarding the use of IIT to treat hyperglycemia in hospitalized medical and surgical patients.
The researchers found that the use of IIT to achieve strict glucose control did not reduce mortality or length of hospital stay but substantially increased the risk of severe hypoglycemia, compared with standard therapy with less strict glucose control. In addition to the cost of implementing IIT, managing consequent harms can also increase costs. Clinicians should aim for blood glucose levels of 7.8–11.1mmol/L (140–200mg/dL).
"Our review of the evidence shows that IIT with a goal of achieving normoglycemia or near-normoglycemia in patients with or without diabetes does not provide any beneficial effects and may lead to harm," Qaseem and colleagues conclude.