Comparison of Routine and Computer-Guided Glucose Management for Glycemic Control in Critically Ill Patients

2019 ◽  
Vol 39 (4) ◽  
pp. 20-27
Author(s):  
Ozlem Canbolat ◽  
Sevgisun Kapucu ◽  
Oguz Kilickaya
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Group ◽  
Routine Clinical Practice ◽  
Target Range ◽  
Control Group ◽  
Intensive Care Patients ◽  
Glucose Management

Background Glycemic control is crucial for reducing morbidity and mortality in critically ill patients. A standardized approach to glycemic control using a computer-guided protocol may help maintain blood glucose level within a target range and prevent human-induced medical errors. Objective To determine the effectiveness of a computer-guided glucose management protocol for glycemic control in intensive care patients. Methods This controlled, open-label implementation study involved 66 intensive care patients: 33 in the intervention group and 33 in the control group. The blood glucose level target range was established as 120 to 180 mg/dL. The control group received the clinic’s routine glycemic monitoring approach, and the intervention group received monitoring using newly developed glycemic control software. At the end of the study, nurse perceptions and satisfaction were determined using a questionnaire. Results The rates of hyperglycemia and hypoglycemia were lower and the blood glucose level was more successfully maintained in the target range in the intervention group than in the control group (P < .001). The time to achieve the target range was shorter and less insulin was used in the intervention group than in the control group (P < .05). Nurses reported higher levels of satisfaction with the computerized protocol, which they found to be more effective and reliable than routine clinical practice. Conclusions The computerized protocol was more effective than routine clinical practice in achieving glycemic control. It was also associated with higher nurse satisfaction levels.

scholarly journals The Effect Of Controlling Hyperglycemia On The Morbidity And Mortality Of Intensive Care Unit (ICU) Patients

2016 ◽  
Vol 12 (18) ◽  
pp. 184
Author(s):  
Hiyam Al-Haqeesh ◽  
Abla Al-Bsoul ◽  
Hussein Shalan ◽  
Aysha Abedalhameed Al-khalaylah ◽  
Nares Musa Ahmad Hakouz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Group ◽  
Target Range ◽  
Control Group ◽  
Management Protocol ◽  
Glucose Management

Introduction: Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes, and the risk of mortality or significant morbidity is high among those who are treated in the intensive care unit (ICU) for more than 5 days. Objective: To assess the effect of glucose management protocol on mortality and morbidity in a heterogeneous population of critically ill adult patients. Design: A randomized controlled trial. Setting: A 24-bed medical-surgical intensive care unit (ICU) for adult patients at King Hussein Medical Center, the Royal Medical Services. Methods: A total of 50 patients who were considered to need intensive care for at least three days, were randomly assigned into two groups. The intervention group subjects were to undergo a glucose control protocol with insulin infusion titrated to maintain blood glucose level in a target range of 120-160 mg/dL; except septic patients, in whom the target was higher, 160- 180 mg/dL. Patients in the second group (control group) were treated by a conventional approach with reduction of blood glucose level only if the level was markedly elevated (>200 mg/dL) to maintain blood glucose level in a target range of 180-200 mg/dL. Results: After adjustment for baseline characteristics the 2 groups of patients were well matched, for age, sex, prevalence of diabetes mellitus, HbA1c value and distribution of diagnoses; the only significant difference was in the percentage of cardiovascular dysfunction, which was higher in the intervention group (p=0.047). After institution of the protocol, the mean blood glucose levels differed significantly between the two treatment groups during the study period (143.70±12.78 mg/dL in the intervention group versus 175.56±14.07 mg/dL in the control group (p<0.001). And patients in the intervention group received a larger mean insulin dose 28.32 ±16.38 units per day, vs. 14.60±12.26 in the control group (p=0.001). The difference in mortality between the two treatment groups was not significant at 28 days (p=0.370) and at 60 days (p=0.555). No significant increase in hypoglycemia episodes was reported in our blood glucose level target. Conclusion: The glucose management protocol resulted in significantly improved glycemic control and was not associated with increased rate of death or hypoglycemia.

scholarly journals Implementation Of Intervention Program For Controlling Glucose Level Among ICU Patients

2016 ◽  
Vol 12 (18) ◽  
pp. 1
Author(s):  
Hiyam Al-Haqeesh ◽  
Shereen Ziad Alhuneity ◽  
Laith A Obeidat ◽  
Ali Sayel Al Rashaydah ◽  
Jebril Ahmed Albedoor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Group ◽  
Target Range ◽  
Control Group ◽  
Management Protocol ◽  
Glucose Management

Introduction: Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes, and the risk of mortality or significant morbidity is high among those who are treated in the intensive care unit (ICU) for more than 5 days. Study objectives: To assess the effect of glucose management protocol on mortality and morbidity in a heterogeneous population of critically ill adult patients. Methods and materials: Study design: A randomized controlled trial. Study setting: Intensive care unit (ICU) for adult patients at King Hussein Medical Center, the Royal Medical Services. Study sample: A total of 50 patients were included in this study and assigned randomly into two groups, control group (N=25), and intervention group (N=25). Study protocol: The intervention group subjects were to undergo a glucose control protocol with insulin infusion titrated to maintain blood glucose level in a target range of 120-160 mg/dL; except septic patients, in whom the target was higher, 160- 180 mg/dL. Patients in the second group (control group) were treated by a conventional approach with reduction of blood glucose level only if the level was markedly elevated (>200 mg/dL) to maintain blood glucose level in a target range of 180-200 mg/dL Study findings: Although the difference in mortality between the two treatment groups was not significant at 28 days (p=0.370) and at 60 days (p=0.555), but it was to be considered for further improvements. No significant increase in hypoglycemia episodes was reported in our blood glucose level target. There was no significant difference in the development of new organ failure, new renal insufficiency, number of patients undergoing transfusion of packed red blood cells, use of antibiotics for more than 10 days, length of stay in the ICU and length of stay in the hospital. It was noticed that the rates of positive blood cultures were lower in the interventional group (8%) than in the control group (32), (p=0.068). Conclusion: The glucose management protocol resulted in significantly improved glycemic control and was not associated with increased rate of death or hypoglycemia.

scholarly journals UJI EFEKTIFITAS SINBIOTIK KEFIR TEPUNG PISANG BATU TERHADAP KADAR GLUKOSA DARAH DAN KADAR PROFIL LIPID TIKUS MODEL SINDROM METABOLIK Effectiveness Test of banana (Musa balbisiana) Flour Kefir Synbiotic on Blood Glucose Level and Lipid Profile Level in Metabolic Syndrome Rats Model

2021 ◽  
Vol 16 (3) ◽  
pp. 296
Author(s):  
Taufik Maryusman ◽  
Christine Diane Dien ◽  
Santi Herlina Mail
Keyword(s):  
Metabolic Syndrome ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Lipid Profile ◽  
Glucose Level ◽  
Intervention Group ◽  
Control Group ◽  
Musa Balbisiana ◽  
Group I ◽  
Bonferroni Test

Metabolic Syndrome is a metabolic disorder characterized by hyperglycemia, hypertriglyceridemia, and dyslipidemia which can be repaired through synbiotics. This study is to analyzed the effects of banana (Musa balbisiana) flour kefir synbiotic on blood glucose level and lipid profile level of Metabolic Syndrome rats. This is true experimental study with pre-posttest with control goup design of 24 male Sprague Dawley rats which were divided into 4 groups randomly. Negative control goup (K-) given standard food only, positive control group (K +) given standard food with High Fat Fructose Diet (HFFD), intervention group I (PI) and intervention group II (PII) were given standard food with HFFD and banana (Musa balbisiana) flour kefir synbiotic 1,8 ml/200 g weight/day (PI) and 3,6 ml/200 g weight/day (PII) for three weeks. Blood glucose level was analyzed using glucose oxidase-peroxidase amino antipyrine method, cholesterol level was analyzed using cholesterol oxidase-peroxidase amino antipyrine, and triglyceride level was analyze using glycerol 3 phosphate oxidase phenol amino phenazone method. Result of Analysis of Varian test shows significant differences in mean between group (p=0,000) followed by PostHoc Bonferroni test or Post Hoc Games-Howel test which showed a mean difference in the PI and PII groups. Banana (Musa balbisiana) flour kefir synbiotic can reduce blood glucose level and improve lipid profile level.

scholarly journals Effect of the Pregnant+ smartphone application in women with gestational diabetes mellitus: a randomised controlled trial in Norway

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030884 ◽  
Author(s):  
Iren Borgen ◽  
Milada Cvancarova Småstuen ◽  
Anne Flem Jacobsen ◽  
Lisa Maria Garnweidner-Holme ◽  
Seraj Fayyad ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Usual Care ◽  
Glucose Level ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Feeding Practice ◽  
Secondary Outcomes ◽  
Randomised Controlled

ObjectiveTo assess the effect of the Pregnant+ app on the 2-hour glucose level of the routine postpartum oral glucose tolerance test (OGTT) among women with gestational diabetes mellitus (GDM). The Pregnant+ app was designed to provide information about GDM, and promote physical activity and a healthy diet.DesignA multicentre, non-blinded randomised controlled trial.SettingFive diabetes outpatient clinics in the Oslo region.ParticipantsWomen ≥18 years old with a 2-hour OGTT blood glucose level ≥9 mmol/L who owned a smartphone; understood Norwegian, Urdu or Somali; and were <33 weeks pregnant. A total of 238 women were randomised; 158 women completed the OGTT post partum.InterventionThe Pregnant+ app and usual care, the control group received usual care.Primary and secondary outcomesThe primary outcome was the 2-hour blood glucose level of the routine postpartum OGTT. Secondary outcomes reported were mode of delivery, induction of labour, Apgar score, birth weight, transfer to the neonatal intensive care unit and breast feeding practice. Blood glucose levels during pregnancy, knowledge of diabetes, diet and physical activity are not reported.ResultsNo difference was found for the 2-hour blood glucose level of the postpartum OGTT, with 6.7 mmol/L (95% CI 6.2 to 7.1) in the intervention group and 6.0 mmol/L (95% CI 5.6 to 6.3) in the control group. The significant difference in the proportion of emergency caesarean sections between the intervention group, 10 (8.8%) and the usual care group, 27 (22.1%), disappeared when adjusted for parity. There were no differences in birth weight, breast feeding practice, obstetric complications or transfer to the intensive neonatal care unit. No adverse events were registered.ConclusionThe Pregnant+ app had no effect on 2-hour glucose level at routine postpartum OGTT. After controlling for parity, the difference in emergency caesarean section was not statistically significant.Trial registration numberNCT02588729.

scholarly journals The Effect of Specific Oral Nutritional Supplements Compared to Tea with Sugar on Gastric Emptying Time, Blood Glucose Level, and Hunger Response in Healthy Adults

2017 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Stella Evangeline Bela ◽  
Luciana Budiati Sutanto ◽  
Jacob Pandelaki
Keyword(s):  
Blood Glucose ◽  
Gastric Emptying ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Group ◽  
Healthy Adults ◽  
Control Group ◽  
Oral Nutritional Supplements ◽  
Gastric Emptying Time ◽  
Emptying Time

Introduction: The objective of this study was to compare gastric emptying time, hunger response, and blood glucose level after drinking specific oral nutritional supplements (S-ONS) to tea with sugar in healthy adults.Methods: This study was a clinical, parallel, random allocation, and single-blind trial. This study was conducted at Cipto Mangunkusumo General Hospital, Jakarta. The subjects were 12 healthy adults divided into 2 groups: intervention group (n = 6) and control group (n = 6). Patients in the intervention group received 200 mL S-ONS (200 kcal, 18% protein, 20% fat and 62% carbohydrate) and control group received 200 mL of tea with 10 grams of sugar (40 kcal). Gastric volume was measured using 2D-sonography every 30 minutes. Blood glucose level was measured using blood peripheral sample. Hunger response was measured using visual analog scale (VAS).Results: Gastric emptying time in the intervention group was <90 minutes, and in the control group <60 minutes. Blood glucose level was increased in the intervention group and decreased in control group. Hunger response was decreased in intervention group and increased in control group.Conclusion: Gastric emptying time after either drinking S-ONS and drinking tea with sugar in healthy adults subjects were less than 2 hours. Patients receiving S-ONS had significantly higher blood glucose level and were less hungry than the control group. 

scholarly journals Designing An Intervention Program To Control Glucose Level In Intensive Care Unit (ICU) In King Hussein Medical Center, Royal Medical Services

2016 ◽  
Vol 12 (18) ◽  
pp. 309
Author(s):  
Neris Musa Ahmad Hakuz ◽  
Amani Mahmoud Al-Tarawneh ◽  
Baraah Walied Amireh ◽  
Husam Alhawari ◽  
Hiyam Al-Haqeesh ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Program ◽  
Medical Center ◽  
Intervention Group ◽  
Mortality Rates ◽  
Control Group ◽  
Icu Patients ◽  
Intervention Protocol

Controlling blood glucose level in ICU is one of the main priorities in ICU to decrease mortality rates and morbidity rates and to decrease the healthcare cost. The main objective of the present study is design and implement an intervention protocol in ICU. The method involved a suggested intervention protocol which was applied for 25 ICU patients and their findings were compared with 25 ICU patients in control group. Study findings showed that the intervention protocol was able to reduce mortality rates, positive blood cultures, decreased morning glucose level in the intervention group compared with control group. As a conclusion, controlling blood glucose level in ICU is considered an appropriate approach and leads to better outcome of the patients.

Nurse-Directed Blood Glucose Management in a Medical Intensive Care Unit

2017 ◽  
Vol 37 (3) ◽  
pp. 30-40 ◽  
Author(s):  
Friederike Compton ◽  
Robert Ahlborn ◽  
Torsten Weidehoff
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Nursing Workload ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Glucose Management

BACKGROUND Insulin-delivery algorithms for achieving glycemic control in the intensive care unit require frequent checks of blood glucose level and thus increase nursing workload. Hypoglycemia is a serious complication associated with intensive insulin therapy. OBJECTIVES To evaluate a nurse-directed protocol for blood glucose management that allows individualized insulin delivery within a predefined blood glucose corridor, intended to avoid hypoglycemia while maintaining adequate control of blood glucose level without increasing nursing workload. METHODS A nurse-directed protocol for blood glucose management was developed by an interprofessional team, and the protocol’s performance was investigated in 175 patients compared with 384 historical controls. RESULTS With the nurse-directed protocol, hypoglycemia incidents declined significantly (31% vs 12%, P &lt; .001), and minimum blood glucose levels increased significantly (80 mg/dL vs 93 mg/dL, P &lt; .001). Mean and maximum blood glucose levels, the proportion of glucose readings within the target range (31% vs 26%, P = .06), and the number of blood glucose checks (59 vs 58, P = .85) remained unchanged with use of the protocol. CONCLUSION Implementation of the nurse-directed protocol for blood glucose management did not increase nursing workload but reduced hypoglycemia incidents significantly while maintaining adequate glycemic control.

Anti-diabetic activity of diphenhydramine in diabetic rats

2020 ◽  
Vol 11 (4) ◽  
pp. 5067-5070
Author(s):  
Pang Jyh Chayng ◽  
Nurul Ain ◽  
Kaswandi Md Ambia ◽  
Rahim Md Noah
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Fasting Blood Glucose ◽  
Insulin Level ◽  
Diabetic Rats ◽  
Group Iv ◽  
Diabetic Rat ◽  
Control Group ◽  
Group I

The purpose of this project is to study the anti-diabetic effect of on a diabetic rat model. A total of Twenty male Sprague rats were used and it randomly distributed into four groups which are Group I: , Group II: negative control, Group III: and Group IV: and . In diabetic model were induced with via injection at the dosage of 65mg/kg. and FBG (Fasting Blood Glucose) level of diabetic rats were assessed every three days. Blood was collected via cardiac puncture at day 21 after the induction of treatment. Insulin level of the rats was assessed with the Mercodia Rat Insulin ELISA kit. FBG level of group I (12.16 ±3.96, p&lt;0.05) and group IV (11.34 ±3.67, p&lt;0.05) were significantly decreased. Meanwhile, the for all rats did not show any significant increase. However, the insulin level was escalated in group IV (0.74+0.25, p&lt;0.05) significantly. The present study shows that the and the combination of and lowered blood glucose level and enhanced insulin secretion.

scholarly journals EFFECTIVENESS OF AMLA JUICE IN REDUCING BLOOD GLUCOSE LEVEL AMONG PATIENTS WITH TYPE II DIABETES IN A SELECTED AREA OF KANYAKUMARI DISTRICT

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mrs. Vanitha. S s ◽  
Dr. Pramjit kaur
Keyword(s):  
Blood Glucose ◽  
Standard Deviation ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Type Ii Diabetes ◽  
Control Group ◽  
Type Ii ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Experimental Group

Challenges in lifestyle, such as increasesin energy intake and decreasesin physical activity are causing overweight and obesity leading to epidemic increases in type II Diabetes Mellitus. The research approach used for this study was evaluative approach and the research design was true experimental design. 60 patients with type II diabetes, 30 in experimental group and 30 in control group were selected for this study by using purposive sampling technique. Data was collected with the help of self-structured interview schedule. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (chi-square, paired ‘t’ test) were used to analyse the data and to test the hypotheses. In the experimental group,the pre-test mean score was 2.966, mean percentage was 59% and standard deviation was 1.129 and in post-testmean score was 2.533, mean percentage was 50.66% and standard deviation was 1.074 with effectiveness of 8.34% and paired‘t’ test value of t=3.971,which was statistically significant (p<0.05) which is an evidence ofthe effectiveness of Amla juice in reducing blood glucose level. Comparison of blood glucose levels in experimental and control groups, shows that the value is statistically highly significant, as was observed from the unpaired ‘t’ test value of 13.39 with P value of <0.05, which is an evidence indicatingthe effect of Amla juice in reducing postprandial blood glucose levels. The resultsfound that the administration of Amla juice did have aneffect in reducing blood glucose level in the experimental group. By comparing the findings of pre-test and post test between the experimental group and the control group,the effect was identified (assessed). The study concluded that the Amlajuice is effective in reducing blood glucose level.

scholarly journals ANTI-HYPERGLYCEMIC EFFECT OF DIFFERENT FRACTIONS OF ANNONA RETICULATA LEAF

2016 ◽  
pp. 256
Author(s):  
Soumya Prakash Rout ◽  
Durga Madhab Kar ◽  
Laxmidhar Maharana
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Ethyl Acetate ◽  
Glucose Level ◽  
Ethyl Acetate Fraction ◽  
Diabetic Control ◽  
Control Group ◽  
Alcoholic Extract ◽  
Diabetic Control Group ◽  
Annona Reticulata

<p>ABSTRACT<br />Context: Several species of the genus Annona were reported to have hypoglycemic properties and this makes Annona reticulata Linn. (Annonaceae)<br />an interesting plant for investigating its anti-hyperglycemic potential.<br />Objective: Different fractions prepared from hydro-alcoholic extract of A. reticulata leave were investigated for their blood glucose lowering effect on<br />Streptozotocin (STZ) induced hyperglycemic rats.<br />Methods: Ethyl acetate, methanol, and residual fractions (at dose level of 100 mg/kg by oral route) prepared from the hydro-alcoholic extract of<br />A. reticulata leave were administered for 14 consecutive days to STZ induced hyperglycemic rats for evaluation of their anti-hyperglycemic potential.<br />Anti-hyperglycemic potential was assessed by observation of a decrease in fasting blood glucose level.<br />Results: The studies revealed that ethyl acetate fraction decreased the blood glucose level of hyperglycemic rats from 447.67 to 234.17 mg/dL and is<br />significant (p&lt;0.001) when compared with diabetic control group. The residual fraction and methanolic fraction decreased blood glucose level from<br />417.83 to 402.50 mg/dL and 432.33 to 371.67 mg/dL respectively but not significant when compared with the diabetic control group. Standard drug<br />metformin (dose 300 mg/kg) reduced the blood glucose level from 447.33 to 219.50 mg/dL.<br />Discussion: Ethyl acetate fraction at tested dose level was capable not only to control the elevated blood glucose level but also able to attenuate<br />certain secondary parameters associated with STZ induced hyperglycemia.<br />Conclusion: This study suggested that the ethyl acetate fraction prepared from hydro-alcoholic extract of A. reticulata leave exhibit potential antihyperglycemic<br />property<br />in the tested<br />experimental<br />models and should be investigated<br />further.<br />Keywords: Streptozotocin, Diabetes, Dyslipidemia.</p>

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