Hypertriglyceridemia‐induced pancreatitis treated with continuous insulin infusion—Case series

2021 ◽  
Author(s):  
Nikolina Marić ◽  
Maja Mačković ◽  
Miro Bakula ◽  
Katarina Mucić ◽  
Nikola Udiljak ◽  
...  
Keyword(s):  
Insulin Infusion ◽  
Case Series ◽  
Continuous Insulin Infusion

scholarly journals Treatment of Severe Hypertriglyceridemia With Insulin Infusions in Severe COVID-19: A Case Series

2021 ◽  
pp. 089719002110104
Author(s):  
Caitlin M. Thomas ◽  
Martie Vicent ◽  
Shawn Moore ◽  
Fahd Ali ◽  
Leslie Wooten ◽  
...  
Keyword(s):  
Insulin Infusion ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Lipid Lowering ◽  
Optimum Dose ◽  
Infusion Therapy ◽  
Lipid Lowering Therapy ◽  
Omega 3 ◽  
Severe Hypertriglyceridemia ◽  
Continuous Insulin Infusion

Purpose: Rapid onset of severe hypertriglyceridemia was quickly recognized in critical COVID-19 patients. Associated causes have been due to secondary hemophagocytic lymphohystiocytosis (HLH) syndrome, medication-induced, or acute liver failure. Statins, omega-3 polyunsaturated acids, niacin, and fibrates are common oral lipid lowering therapy options in patients at risk for hypertriglyceridemia. The severity of hypertriglyceridemia in COVID-19 patients with triglyceride values reaching greater than 1,000 mg/dL put them at a heightened risk of pancreatitis and therefore an essential need to acutely lower their levels. We present a case series of 5 patients who achieved rapid triglyceride lowering through continuous insulin infusion therapy. Methods: A retrospective chart review of 48 critical COVID-19 patients who were admitted from March 22 to April 15, 2020 was conducted. Inclusion criteria consisted of mechanical ventilation and continuous insulin infusion to treat severe hypertriglyceridemia resulting with 5 eligible patients in this case report. Results and Conclusion: In addition to standard oral lipid lowering therapies, continuous insulin infusion successfully treated severe hypertriglyceridemia in critically ill COVID-19 patients. None of the patients experienced pancreatitis or hypoglycemia necessitating cessation of insulin. Further studies are needed to show the optimum dose and duration of insulin infusion as monotherapy and in combination with oral therapies.

Platelet function during continuous insulin infusion treatment in insulin-dependent diabetic patients

Diabetes ◽  
1985 ◽  
Vol 34 (11) ◽  
pp. 1127-1133 ◽  
Author(s):  
R. K. Mayfield ◽  
P. V. Halushka ◽  
H. J. Wohltmann ◽  
M. Lopes-Virella ◽  
J. K. Chambers ◽  
...  
Keyword(s):  
Platelet Function ◽  
Insulin Infusion ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Continuous Insulin Infusion

Role of gluconeogenesis in sustaining glucose production during hypoglycemia caused by continuous insulin infusion in conscious dogs

Diabetes ◽  
1988 ◽  
Vol 37 (6) ◽  
pp. 749-759 ◽  
Author(s):  
R. T. Frizzell ◽  
G. K. Hendrick ◽  
D. W. Biggers ◽  
D. B. Lacy ◽  
D. P. Donahue ◽  
...  
Keyword(s):  
Insulin Infusion ◽  
Glucose Production ◽  
Conscious Dogs ◽  
Continuous Insulin Infusion

A NOVEL USE OF U-500 INSULIN FOR CONTINUOUS SUBCUTANEOUS INSULIN INFUSION IN PATIENTS WITH INSULIN RESISTANCE: A CASE SERIES

2003 ◽  
Vol 9 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Treyce S. Knee, MD, FACE ◽  
Daniel F. Seidensticker, MD ◽  
Judy L. Walton, RNC, FNP, CDE ◽  
Larissa M. Solberg, RN, CDE ◽  
David H. Lasseter, MD, FACE
Keyword(s):  
Insulin Resistance ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Case Series ◽  
Subcutaneous Insulin

Simplified Approach to Incorporating Glycemic Response Within a Continuous Insulin Infusion Algorithm to Improve the Incidence of Hypoglycemia in a Single Burn Center

2020 ◽  
Vol 41 (4) ◽  
pp. 791-795
Author(s):  
Hayden A Hendrix ◽  
Sai R Velamuri ◽  
Ibrahim Sultan-Ali ◽  
Faisal Arif ◽  
William L Hickerson ◽  
...  
Keyword(s):  
Insulin Infusion ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Burn Patients ◽  
Glycemic Response ◽  
Simplified Approach ◽  
Thermal Injuries ◽  
Continuous Insulin Infusion ◽  
Related Mortality

Abstract Attaining adequate glycemic control in burn patients has been shown to reduce infection-related mortality. Previous internal evaluation of continuous insulin infusion (CII) use revealed a hypoglycemia rate of 0.6% and an average time within goal glycemic range (70–149 mg/dl) of 13.8 h/day. A new algorithm, designed to adjust dosage based on glycemic response, underwent six iterations over 2 years before the final version was implemented. The purpose of this retrospective study was to assess the post-implementation performance of the newly developed CII algorithm. The current study was powered to detect a 50% reduction in hypoglycemic events, as compared to a pre-implementation historical control. The cohort was 62% male with a mean age of 54.5 ± 17.4. Sixty-five percent had thermal injuries with a median 23.5 (11–45) %TBSA. There were no differences in demographics between groups. Among the 20 records reviewed, 5239 point-of-care glucose values were assessed. Post-implementation, hypoglycemia rates were significantly lower (0.6% vs 0.2%; P < .001). There was no difference in median blood glucose between groups (149.9 vs 146.5 mg/dl; P = .56). Time spent within goal glycemic range was not significantly different (13.8 vs 14.7 h/day; P = 0.23). There were no differences in infection, length of stay, or survival. The consolidation, education, and implementation of a single, dynamic CII algorithm reduced the incidence of hypoglycemia. The authors expect that education and diligence with follow-up glucose monitoring will further improve time within goal glycemic range by preventing rebound hyperglycemia.

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