Document Detail


Intensive insulin therapy versus conventional glycemic control in patients with acute neurological injury: a prospective controlled trial.
MedLine Citation:
PMID:  17952272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare intensive insulin therapy to conventional glycemic control in patients with acute neurological injury evaluating neurological outcome and morbimortality. METHOD: Patients with two glycemias above 150 mg/dL 12 hours after admission were randomized to receive intensive insulin therapy (G1) or conventional treatment (G2). We evaluated a subgroup of patients with acute brain injury from July, 2004 to June, 2006. RESULTS: G1 patients (n=31) received 70.5 (45.1-87.5) units of insulin/day while G2 patients (n=19) received 2 (0.6-14.1) units/day (p<0.0001). The median glycemia was comparable in both groups (p=0.16). Hypoglycemia occurred in 2 patients (6.4%) in G1 and in 1 patient (5.8%) in G2 (p=1.0). Mortality in G1 was of 25.8% and of 35.2% in G2 (relative reduction of 27%). Neurological outcome was similar in both groups. CONCLUSION: A less strict intensive insulin therapy can reduce hypoglycemia and still maintain its benefits.
Authors:
José Raimundo A de Azevedo; Eduardo Rodrigues M Lima; Rachel Jorge Dino Cossetti; Renato Palácio de Azevedo
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Arquivos de neuro-psiquiatria     Volume:  65     ISSN:  0004-282X     ISO Abbreviation:  Arq Neuropsiquiatr     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2008-05-01     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0125444     Medline TA:  Arq Neuropsiquiatr     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  733-8     Citation Subset:  IM    
Affiliation:
Intensive Care Units of Hospital São Domingos and Hospital Dr. Clementino Moura, 65072-820 São Luis, MA, Brazil. jrazevedo@elo.com.br
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Blood Glucose / analysis*
Brain Injuries / complications,  drug therapy*,  mortality
Female
Glasgow Outcome Scale
Humans
Hyperglycemia / etiology,  prevention & control*
Hypoglycemic Agents / administration & dosage*
Insulin / administration & dosage*
Insulin Infusion Systems
Intensive Care Units
Length of Stay
Male
Middle Aged
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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