Can we Provide Effective Glycemic Control in Intensive Care Unit? Point Prevalence Study

Abstract

Objective: Blood glucose dysregulation is independently associated with mortality and morbidity in critically ill patients. However, it is difficult to keep glycemic control at targeted levels in diabetic and non-diabetic patients in intensive care units (ICU). A point prevalence study was planned to evaluate glycemic control in patients treated in the tertiary ICU. Ethics committee approval was obtained before starting the study. Methods: The demographic data of the patients, their characteristics at the time of admission, intensive care follow-up and treatment, the nutrition method, and the parameters related to glycemic control were recorded. Results: On the study day, a total of 107 patients, 35 of whom were COVID (C-ICU) and 72 were in the non-Covid ICU (NC-ICU), were included in the study. 47.6% of the patients were male and 29.9% had a diagnosis of diabetes mellitus (DM). The mean blood glucose value of the patients was measured as 158 mg/dL and glycemic dysregulation (4.7% hypoglycemia and 25.2% hyperglycemia) was detected in 29.9% of all patients. Blood glucose levels were unregulated in 28.6% (n=10) of the patients in C-ICU and 30.5% (n=22) patients in NC-ICU. The patients with regulated blood glucose were similar between the two groups (p=0.510). A statistically significant correlation was found between the patients’ unregulated blood glucose levels and the presence of DM (p=0.05). Conclusion: The idea that a certain glucose target may not always be optimal for all patients and that individualized glucose control is currently being discussed. We believe that blood glucose algorithms are necessary in ICUs without putting patients into hypoglycemia or hyperglycemia in routine follow-up. ABSTRACT