Residents and Fellows Research in Progress
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction: Hyperglycemia is common in patients in intensive care units even without a prior medical history of diabetes. Hyperglycemia during illness is fueled by a state of insulin resistance caused by counter-regulatory hormones and elevated levels of cytokines. However, studies have shown that the benefit of tight glycemic control may not outweigh the increased risk of morbidity and mortality associated with hypoglycemia. Many patients in the ICU are treated for septic shock and stress dose steroids (SDS) are often initiated. Hyperglycemia is one of the first adverse effects of corticosteroids with as many as 86% of patients on corticosteroids experiencing at least one episode of hyperglycemia.
Research Question or Hypothesis: To compare blood glucose and patient outcomes in those receiving intermediate vs long-acting insulin in the management of SDS.
Study Design: Retrospective chart review
Methods: Single-center retrospective review of glucose control in patients on SDS in a critical care setting. This study aims to assess blood glucose levels, insulin requirements, and rates of hypoglycemia in adults receiving SDS therapy. The primary outcome of this study is the time within a goal blood glucose range of 8 during and after utilization of SDS. Secondary outcomes include rates of hypoglycemia (blood glucose <70 mg/dL) and average daily insulin requirements before and after steroid discontinuation. Descriptive statistics will be used, and where appropriate use of Chi-squared testing for inter-cohort comparison.
Results: To be collected
Conclusion: To be reported
Presenting Author
Hannah Goddard PharmDLahey Hospital & Medical Center
Authors
Jason Lancaster PharmD, MEd, BCPS
Lahey Hospital & Medical Center
Leah Mangini PharmD
Lahey Hospital & Medical Center