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At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2017

Open Access 01-12-2017 | Research

Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial

Authors: Stéphanie Genay, Bertrand Décaudin, Sabine Ethgen, Arnaud Alluin, Elodie Babol, Julien Labreuche, Hélène Behal, Marie-Christine Vantyghem, Pascal Odou, Gilles Lebuffe

Published in: Annals of Intensive Care | Issue 1/2017

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Background

Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomised study was conducted in a fifteen-bed perioperative high dependency unit (HDU) in a university hospital. In total, 172 eligible patients receiving insulin therapy agreed to participate in the study. Subcutaneous continuous glucose monitoring was set up for all patients and an optimised system with a dedicated insulin infusion line for half of the patients.

Results

Eighty-six patients were infused via the optimised infusion line and 86 patients via the standard infusion line. No significant difference was found according to the glycaemic lability index score [mean difference between groups (95% CI): −0.09 (−0.34; 0.16), p = 0.49 after multiple imputation]. A glucose control monitoring system indicated a trend towards differences in the duration of hypoglycaemia (blood glucose level below 70 mg dl−1 (3.9 mmol l−1) over 1000 h of insulin infusion (9.7 ± 25.0 h in the standard group versus 4.4 ± 14.8 h in the optimised group, p = 0.059) and in the number of patients experiencing at least one hypoglycaemia incident (25.7 vs. 12.9%, p = 0.052). Time in the target range was similar for both groups.

Conclusions

The use of optimised infusion line with a dedicated insulin infusion line did not reduce glycaemic variability but minimised the incidence of hypoglycaemia events. The choice of the medical devices used to infuse insulin seems important for improving the safety of insulin infusion in perioperative HDU.
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Metadata
Title
Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial
Authors
Stéphanie Genay
Bertrand Décaudin
Sabine Ethgen
Arnaud Alluin
Elodie Babol
Julien Labreuche
Hélène Behal
Marie-Christine Vantyghem
Pascal Odou
Gilles Lebuffe
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2017
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0298-x

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