Opinions and practices of blood glucose control in critically ill patients with pre-existing type 2 diabetes in Australian and New Zealand intensive care units.

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  • Additional Information
    • Source:
      Publisher: Confederation of Australian Critical Care Nurses Country of Publication: Australia NLM ID: 9207852 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1036-7314 (Print) Linking ISSN: 10367314 NLM ISO Abbreviation: Aust Crit Care
    • Publication Information:
      Publication: North Strathfield : Confederation of Australian Critical Care Nurses
      Original Publication: North Strathfield, NSW : The Confederation, [1992-
    • Subject Terms:
      Critical Illness*; Blood Glucose/*analysis ; Diabetes Mellitus, Type 2/*blood; Adult ; Australia ; Female ; Health Care Surveys ; Humans ; Intensive Care Units ; Male ; New Zealand ; Self Report
    • Abstract:
      Background: Approximately 9000 patients with type-2 diabetes mellitus (T2DM) are admitted to an intensive care unit (ICU) in Australia and New Zealand annually. For these patients, recent exploratory data suggest that targeting a more liberal blood glucose range during ICU admission may be safe and potentially beneficial. However, the current approach to blood glucose management of patients with T2DM in Australia and New Zealand ICUs is not well described, and there is uncertainty about clinician equipoise for trials of liberal glycaemic control in these patients.
      Aim: The aim is to describe self-reported blood glucose management in patients with T2DM by intensivists working in Australian and New Zealand ICUs and to establish whether equipoise exists for a trial of liberal versus standard glycaemic control in such patients.
      Method: An online questionnaire of Australia and New Zealand intensivists conducted in July-September 2016.
      Results: Seventy-one intensivists responded. Forty-five (63%) used a basic nomogram to titrate insulin. Sixty-six (93%) reported that insulin was commenced at blood glucose concentrations >10 mmol/L and titrated to achieve a blood glucose concentration between 6.0 and 10.0 mmol/L. A majority of respondents (75%) indicated that there was insufficient evidence to define optimal blood glucose targets in patients with T2DM, and 59 (83%) were prepared to enrol such patients in a clinical trial to evaluate a more liberal approach.
      Conclusion: A majority of respondents were uncertain about the optimal blood glucose target range for patients with T2DM and would enrol such patients in a comparative trial of conventional versus liberal blood glucose control.
      (Copyright © 2018 Australian College of Critical Care Nurses Ltd. All rights reserved.)
    • Contributed Indexing:
      Keywords: Attitude; Blood glucose; Critical care; Critical illness; Diabetes mellitus; Intensive care units; Surveys and questionnaires; Type 2
    • Accession Number:
      0 (Blood Glucose)
    • Publication Date:
      Date Created: 20181024 Date Completed: 20200831 Latest Revision: 20200831
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.aucc.2018.09.001
    • Accession Number:
      30348487