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Intravenous insulin for the management of non-emergent hyperglycemia in the emergency department
- Source :
- The American Journal of Emergency Medicine. 45:335-339
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- There is currently no consensus regarding the necessity of emergency department (ED) glucose reduction to manage hyperglycemia in patients presenting without a hyperglycemic emergency. Known consequences of intravenous (IV) insulin administration include hypoglycemia, hypokalemia, and increased ED length of stay. The primary objective of this study was to assess the impact of IV regular insulin on glucose reduction and ED length of stay in patients presenting to the ED with non-emergent hyperglycemia. Secondary objectives included the characterization of potential adverse events.This was a retrospective, observational study of patients ≥18 years who received IV regular insulin and were discharged from the ED at a large academic Trauma Center. Univariate and multivariable regression analyses were utilized to determine if an association existed between IV insulin administration and blood glucose as well as ED length of stay.A total of 405 patients were included in the analysis. An insulin dose5 units was associated with a greater reduction in blood glucose (difference = 37.4 mg/dL; p .001) but no difference in ED length of stay relative to ≤5 units. Furthermore, 7.9% of patients developed hypokalemia and 0.4% developed hypoglycemia.The use of5 units of IV regular insulin for the management of isolated hyperglycemia in the ED was associated with a modest reduction in blood glucose and no difference in ED length of stay compared with those that received ≤5 units. However, use of IV insulin for this purpose resulted in a 7.9% occurrence of hypokalemia.
- Subjects :
- Adult
Blood Glucose
Male
medicine.medical_specialty
medicine.medical_treatment
Pharmacy
Hypoglycemia
03 medical and health sciences
0302 clinical medicine
Internal medicine
Humans
Hypoglycemic Agents
Insulin
Medicine
Adverse effect
Retrospective Studies
business.industry
Trauma center
030208 emergency & critical care medicine
General Medicine
Emergency department
Length of Stay
Middle Aged
medicine.disease
Hypokalemia
Hyperglycemia
Emergency Medicine
Regular insulin
Administration, Intravenous
Female
medicine.symptom
Emergency Service, Hospital
business
Subjects
Details
- ISSN :
- 07356757
- Volume :
- 45
- Database :
- OpenAIRE
- Journal :
- The American Journal of Emergency Medicine
- Accession number :
- edsair.doi.dedup.....b1ace8e71242d7ffefbd44fdd09ce2b9