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Table 4 Summary of several insulin infusion protocols in different ICU settings

From: A comparison of two insulin infusion protocols in the medical intensive care unit by continuous glucose monitoring

Authors ICU type Study n % Diabetic patients Protocol Target glycemia (mg/dl) Method of glucose measurements
Goldberg et al. (2004) MICU Observational 52 56 Yale 100–139 Hospital glucose meter: near hourly measurements
Van den Berghe et al. (2006) MICU RCT 1200 17 Paper: Leuven 80–110 ABG: q1-4 h
Kulnik et al. (2008) MICU Observational 10 20 eMPC (computer) 80–110 Variable sampling rate: q20 min-4 h
Shetty et al. (2012) MICU Observational 90 66 Yale 120–160 POC meter: hourly measurements
Holzinger et al. (2010) MICU RCT 124 19 Leuven 80–110 CGM
De Block et al. (2015) MICU RCT 35 23 Yale 80–110 CGM
Finney et al. (2003) Mixed Observational 523 16 Paper 90–145 ABG
Juneja et al. (2007) Mixed Observational 2398 NR Clarian Gluco Stabilizer 80–110 POC: q1-2 h
Chase et al. (2008) Mixed Observational 371 17 SPRINT 80–110 Sampling rate: q1-2 h
Morris et al. (2008) Mixed Before–after 755 NR eProtocol-insulin versus paper 80–110 POC: q1-4 h
Preiser et al. GLUCONTROL (2009) Mixed RCT 1078 21 Paper: glucontrol 80–110 POC: q1-4 h
NICE SUGAR (2009) Mixed RCT 6104 20 Paper: Leuven 81–108 ABG
Marvin et al. (2013) Mixed Retrospective 1657 NR Computerized Yale 100–140 POC: variable time interval
Van Herpe et al. (2013) Mixed RCT 300 21 LOGIC-insulin computerized 80–110 ABG: variable time interval: q1-4 h
Krinsley et al. (2015) Mixed Retrospective 3297 23 Paper: Stamford 70–140 POC: q3 h
Vogelzang et al. (2005) SICU Observational 179 15 GRIP 72–135 POC blood gas analyzer: variable
Plank et al. (2006) SICU: cardiothoracic surgery RCT 60 23 eMPC versus paper 80–110 POC: variable sampling rate: q1 h-4 h
Hovorka et al. (2007) SICU: cardiac surgery RCT 60 45 eMPC 80–110 Variable sampling rate: q1 h-4 h
Saager et al. (2008) SICU: cardiothoracic ICU RCT 40 100 EndoTool (computer) versus paper 90–150 POC: hourly
Dortch et al. (2008) SICU: trauma ICU RCT 552   Computer versus paper 80–110 POC q1-4 h
Blaha et al. (2009) SICU: cardiac surgery RCT 120 14 eMPC versus paper (Matias versus Bath) 80–110 ABG: protocol dependent: q1-4 h
Barletta et al. (2011) SICU Before–after 192 28 Computer versus paper 80–110 POC: variable sampling rate: q30 min-2 h versus q2 h
Dumont et al. (2012) SICU: cardiovascular ICU RCT 300 43 Computer (EndoTool) versus paper (modified Portland) 80–150 NA
Authors Duration of glucose monitoring Glucometric to measure target % of time at target glycemia: intervention versus control group Mean glycemia (mg/dl): intervention versus control group Hypoglycemia: intervention versus control group Glycemic variability References
Goldberg et al. (2004) 61 h Percent of hourly BG values in target range 52% 124 ± 15 % of data at glc <60 mg/dl: 0.3% NA [8]
Van den Berghe et al. (2006) NR Mean morning BG NA 111 ± 29 versus 153 ± 31 % of patients: glc <40 mg/dl: 18.7 versus 3.1% NA [13]
Kulnik et al. (2008) 72 h Percent of BG values in target 47 ± 13% 109 ± 13 % data at glc <40 mg/dl: 0% NA [15]
Shetty et al. (2012) 59 h Percent of BG values in target range 42% 156 ± 23 % of data <70 mg/dl: 0.3% NA [37]
Holzinger et al. (2010) 72 h CGM data: percent of data in target range 59 ± 20 versus 55 ± 18 106 ± 18 versus 111 ± 10 Rate: 1.9% versus 11.5% NA [9]
De Block et al. (2015) 96 h CGM data: percent of data in target range 37 ± 12 versus 34 ± 10 119 ± 17 versus 122 ± 11 % of time at glc <60 mg/dl: 0.6 ± 1.6 versus 2.4 ± 4.3% No differences between groups in SD, MAGE, MODD, CV [6]
Finney et al. (2003) 22–89 h Time spent in glucose band 80–110 mg/dl 4 (0–20)% NR 0 ± 1% NA [31]
Juneja et al. (2007) NR Percent of data in target range 52 versus 32% 107 ± 39 % data at glc <50 mg/dl: 0.4 versus 0.5% NA [10]
Chase et al. (2008) 53 h Percent of BG values in target 54% 108 ± 27 % of data at glc <72 mg/dl: 3.8% SD: 27 mg/dl [4]
Morris et al. (2008) 4–22 days Percent of BG values in target 42 versus 28% 116 versus 134 % data at glc <40 mg/dl: 11.1 versus 5.1% NA [11]
Preiser et al. GLUCONTROL (2009) 48–216 h (=2–9 days) Proportion of time of BG values in range 43% 117 (IQR: 108–130) mg/dl Proportion of time at glc <40 mg/dl: 5.9 ± 27% SD: 36 mg/dl [12]
NICE SUGAR (2009) 4.2 days (1.9–9.0 days) Time-weighted mean BG NR 115 ± 18 versus 144 ± 23 % of patients: glc <40 mg/dl: 6.8 versus 0.5% NA [7]
Marvin et al. (2013) NR Percent of hourly BG values in target range 92% 124 % of data 40–70 mg/dl: 1.1% and in 17.6% of patients NA [34]
Van Herpe et al. (2013) 26–113 h Percent of BG values in target range 69 ± 17 versus 60 ± 19 106 ± 9 versus 107 ± 11 % data at glc <60 mg/dl: 0.6 versus 1.2% Max change in glc/24 h: 31 versus 37 mg/dl [14]
Krinsley et al. (2015) 36–120 h Percent of time of BG values in target range Non-DM versus DM: 81 (61–94) versus 55 (35–71)% Non-DM versus DM: 121 (112–133) versus 140 (128–155) mg/dl % of patients: glc <70 mg/dl: non-DM versus DM: 18 versus 31% CV: non-DM versus DM: 18 versus 27% [33]
Vogelzang et al. (2005) 1.6 (0.8–4.7) days Percent of time of BG values in target 78 (66–88)% 121 (108–135) % of patients: glc <40: 0.6%; glc <63: 11.2% NA [38]
Plank et al. (2006) 48 h Percent of time in target range 52 (17–92) versus 19 (0–71)% 117 (102–144) versus 131 (97–237) Number of hypo episodes (<54 mg/dl) over 48 h: 0 versus 2 NA [35]
Hovorka et al. (2007) 24 h Percent of time in target range 60 ± 23 versus 28 ± 16 112 ± 20 versus 130 ± 20 % of data at glc <52 mg/dl: 0% versus 0% NA [32]
Saager et al. (2008) 9 h Percent of BG values in target 84 versus 60% 126 ± 18 versus 147 ± 27 Episodes of hypo (<60 mg/dl) during ICU: 4 versus 1 NA [36]
Dortch et al. (2008) NR Percent of BG values in target 42 versus 34% 116 ± 37 versus 120 ± 37 % data at glc <40 mg/dl: 0.2 versus 0.5% NA [30]
Blaha et al. (2009) 45–48 h Time in target range 46 ± 3 versus 38 ± 3 versus 40 ± 3% 106 ± 4 versus 121 ± 4 versus 117 ± 4 Time in hypo (<52 mg/dl): 0 ± 0 versus 0.4 ± 0.2 versus 0.4 ± 0.3% NA [18]
Barletta et al. (2011) 67 versus 98 h Percent of BG values in target 49 ± 14 versus 40 ± 12 113 ± 11 versus 116 ± 11 % data at glc <40 mg/dl: 2.1 versus 4.1% SD: 25 ± 9 versus 31 ± 11 mg/dl [29]
Dumont et al. (2012) NA Percent of BG values in target range 70 ± 15 versus 62 ± 18 138 ± 16 versus 141 ± 20 Number of hypo events <60 mg/dl: 7 (5%) versus 18 (11%) SD:36 ± 18 versus 42 ± 21 [19]
  1. MICU medical intensive care unit, SICU surgical ICU, RCT randomized controlled trial, NR not reported, NA not assessed, ABG arterial blood glucose, POC point of care, SD standard deviation