Using intensive intravenous insulin therapy is the recommended method of diabetes management in critically ill persons in hospitals. However, there is still want of an intravenous insulin protocol that is robust enough to control glucose levels in sick patients and simple enough to be used throughout the hospital without close expert supervision.
A team from Atlanta Diabetes Associates, Georgia, led by Paul C. Davidson has developed a computer-directed algorithm for advice on the delivery of intravenous insulin that is flexible in blood glucose timing and advises insulin dosing in a graduated manner. The tool for blood glucose management
In a study conducted by this group, the data from 5,080 intravenous insulin runs over 120,683 h show that blood glucose levels can be safely stabilized in a target range without significant hypoglycemia by non-specialized nurses working on any unit of a general hospital. No hypoglycemia was found severe.
As highlighted in an article published in the October issue of Diabetes Care, this computer-directed algorithm is a simple, safe, effective, and robust method for maintaining glycemic control. It has been extensively studied and is applicable in a wide variety of conditions. In contrast to other published intravenous insulin protocols, which have been limited to intensive care units, Glucommander can be used in all units of any hospital.
Abbreviations: Computerized Hospital Insulin Project, intensive care unit, Glucommander