ICU sedation, delirium & recovery
Insulin requirement trajectories during COVID ‐19 versus non‐ COVID ‐19 critical illness—A retrospective cohort study
Main finding · Mean daily ICRResult — go to the resultRisk estimate (interaction COVID-19 × ICU-day) 1.22 95% CI 1.15–1.31Authors' conclusion
In our cohort of ICU patients, COVID-19 was associated with higher daily insulin requirements per gram of administered carbohydrates, and worse glycemic control. We found no robust association between ICR and increased odds of death at 90 days.
Study context
- Population
- Intensive care unit (ICU) patients with or without COVID-19
- Participants
- 350 vs 1,067
- Exposure
- COVID-19 vs non-COVID-19 critical illness
- COVID-19n = 350
- non-COVID-19n = 1,067reference
- Outcome
- Insulin requirement (insulin-to-carbohydrate ratio, ICR: total units of exogenous insulin per gram of administered carbohydrates), daily
Methodological detailsobservational, multivariable generalized linear mixed-model (GLMM), multivariable logistic regression
- Observational
- Multivariable GLMM
- Multivariable logistic regression
Main finding
Mean daily ICR
Risk estimate (interaction COVID-19 × ICU-day)
1.22
95% CI 1.15–1.31
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mean daily ICR, patients without diabetes
P = 0.01
Mean daily ICR, patients with diabetes
P = 0.32
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| 90-day mortality per one unit increase in mean ICR · multivariable logistic regression | 1.77 (0.94–3.34) | P = 0.076 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Glycemic control
- COVID-19 associated with higher average glucose, more pronounced glucose variability and lower proportion of glucose values within target range among patients without diabetes
Safety
- COVID-19 associated with higher hypoglycemia prevalence irrespective of diabetes status
Original publication
Insulin requirement trajectories during COVID ‐19 versus non‐ COVID ‐19 critical illness—A retrospective cohort study. Acta Anaesthesiol Scand. Published 14 October 2024. doi:10.
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