Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19763
Title: Opinions and practices of blood glucose control in critically ill patients with pre-existing type 2 diabetes in Australian and New Zealand intensive care units.
Austin Authors: Poole, Alexis P;Anstey, James;Bellomo, Rinaldo ;Biradar, Vishwanath;Deane, Adam M;Finfer, Simon R;Finnis, Mark E;French, Craig J;Kar, Palash;Kruger, Peter S;Maiden, Matthew J;Mårtensson, Johan;McArthur, Colin J;McGuinness, Shay P;Secombe, Paul J;Tobin, Antony E;Udy, Andrew A;Eastwood, Glenn M 
Affiliation: Department of Intensive Care, Princess Alexandra Hospital, Australia
School of Medicine, University of Queensland, Australia
Department of Intensive Care, Royal Melbourne Hospital, Australia
Department of Intensive Care, Lyell McEwin Hospital, Australia
Intensive Care
Discipline of Acute Care Medicine, University of Adelaide, Australia
Department of Intensive Care, The Alfred Hospital, Australia
Department of Intensive Care, St Vincent's Hospital, Melbourne, Australia
Department of Intensive Care, Alice Springs Hospital, Australia
Cardiothoracic and Vascular Intensive Care and High Dependency Unit, Auckland District Health Board, Australia
Department of Critical Care Medicine, Auckland District Health Board, Australia
Department of Intensive Care, Geelong Hospital, Australia
Department of Intensive Care, Royal Adelaide Hospital, Australia
Department of Intensive Care, Western Health, Australia
The George Institute for Global Health, University of New South Wales, Sydney, Australia
Issue Date: Sep-2019
Date: 2018-10-19
Publication information: Australian Critical Care 2019; 32(5): 361-365
Abstract: Approximately 9000 patients with type-2 diabetes mellitus (T2DM) are admitted to an intensive care unit (ICU) in Australia and New Zealand annually. For these patients, recent exploratory data suggest that targeting a more liberal blood glucose range during ICU admission may be safe and potentially beneficial. However, the current approach to blood glucose management of patients with T2DM in Australia and New Zealand ICUs is not well described, and there is uncertainty about clinician equipoise for trials of liberal glycaemic control in these patients. The aim is to describe self-reported blood glucose management in patients with T2DM by intensivists working in Australian and New Zealand ICUs and to establish whether equipoise exists for a trial of liberal versus standard glycaemic control in such patients. An online questionnaire of Australia and New Zealand intensivists conducted in July-September 2016. Seventy-one intensivists responded. Forty-five (63%) used a basic nomogram to titrate insulin. Sixty-six (93%) reported that insulin was commenced at blood glucose concentrations >10 mmol/L and titrated to achieve a blood glucose concentration between 6.0 and 10.0 mmol/L. A majority of respondents (75%) indicated that there was insufficient evidence to define optimal blood glucose targets in patients with T2DM, and 59 (83%) were prepared to enrol such patients in a clinical trial to evaluate a more liberal approach. A majority of respondents were uncertain about the optimal blood glucose target range for patients with T2DM and would enrol such patients in a comparative trial of conventional versus liberal blood glucose control.
URI: https://ahro.austin.org.au/austinjspui/handle/1/19763
DOI: 10.1016/j.aucc.2018.09.001
ORCID: 0000-0002-1650-8939
Journal: Australian Critical Care
PubMed URL: 30348487
ISSN: 1036-7314
Type: Journal Article
Subjects: Attitude
Blood glucose
Critical care
Critical illness
Diabetes mellitus
Intensive Care Units
Surveys and questionnaires
Type 2
Appears in Collections:Journal articles

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