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Letters |21 June 2011

Intensive Insulin Therapy in Hospitalized Patients

Rajesh Garg, MD

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Potential Conflicts of Interest: None disclosed.
  • From Brigham and Women's Hospital, Boston, MA 02115.
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Potential Conflicts of Interest: None disclosed.
TO THE EDITOR:
Qaseem and colleagues' clinical practice guideline for the management of hyperglycemia in hospitalized patients (1) is confusing and may do more harm than good. The guideline recommends against use of IIT in the ICU as well as in the non-ICU setting, regardless of the diabetes status of the patient. Intensive insulin therapy is defined as the use of intravenous insulin infusion; if intravenous insulin infusion should not be used in the ICU, what should be used to keep blood glucose levels in the target range of 7.8 to 11.1 mmol/L (140 to 200 mg/dL)? Should it be oral agents, multiple subcutaneous insulin injections, or a sliding-scale insulin regimen?
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Garg R. Intensive Insulin Therapy in Hospitalized Patients. Ann Intern Med. 2011;154:846. doi: 10.7326/0003-4819-154-12-201106210-00020

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Published: Ann Intern Med. 2011;154(12):846.

DOI: 10.7326/0003-4819-154-12-201106210-00020

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