Proof-of-Concept Study of Insulin Glargine as Basal Insulin Support for Recovering Critically Ill Patients

Intravenous insulin is commonly used to maintain normoglycaemic in the Christchurch Hospital Intensive Care Unit (ICU). The current standard protocol, SPRINT, uses intravenous insulin injections every 1-2 hours and controls the blood glucose levels very effectively. However, once patients leave the ICU, the standard protocols in the general wards are to use subcutaneous insulin, often due to the lack of intravenous lines and nursing resource. Currently, the guidelines for switching patients from intravenous to subcutaneous insulin are unclear, resulting in inconsistent levels of care. Therefore ward patients do not continue to benefit from tight blood glucose control. There is a need for a system, which can maintain good blood glucose control outside of ICU that can follow patients from ICU to less acute wards, while keeping nursing effort to a minimum. This study will first validate the Glargine pharmacokinetics model developed by the investigator’s group and test the effectiveness of Glargine as basal insulin support in the ICU populations. These steps are necessary before expending glycaemic control to less acute wards.