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Baseline insulin/glucose ratio as a marker for the clinical course of hyperglycemic critically ill children treated with insulin

Abstract Objective The objective of this study was to investigate the relations of baseline insulin/glucose ratio to the clinical course of critically ill children. Such information will provide insight into the pathophysiologic mechanisms leading to hyperglycemia and will optimize preventive and th... Full description

Journal Title: Nutrition (Burbank Los Angeles County, Calif.), 2012, Vol.28 (1), p.25-29
Main Author: Verhoeven, Jennifer J., M.D
Other Authors: Koenraads, Marianne, M.D , Hop, Wim C.J., Ph.D , Brand, Jeannette B., R.N , van de Polder, Mirjam M., R.N , Joosten, Koen F.M., Ph.D
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0899-9007
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title: Baseline insulin/glucose ratio as a marker for the clinical course of hyperglycemic critically ill children treated with insulin
format: Article
creator:
  • Verhoeven, Jennifer J., M.D
  • Koenraads, Marianne, M.D
  • Hop, Wim C.J., Ph.D
  • Brand, Jeannette B., R.N
  • van de Polder, Mirjam M., R.N
  • Joosten, Koen F.M., Ph.D
subjects:
  • Adolescent
  • Algorithms
  • Biological and medical sciences
  • Biomarkers - blood
  • Blood Glucose - analysis
  • Child
  • Child, Preschool
  • Children & youth
  • Critical illness
  • Dextrose
  • Diabetes
  • Drug Monitoring
  • Feeding. Feeding behavior
  • Female
  • Fundamental and applied biological sciences. Psychology
  • Gastroenterology and Hepatology
  • Glucose
  • Hospitals, Pediatric
  • Hospitals, University
  • Humans
  • Hyperglycemia
  • Hyperglycemia - complications
  • Hyperglycemia - drug therapy
  • Hyperglycemia - etiology
  • Hyperglycemia - metabolism
  • Hyperinsulinism - etiology
  • Hyperinsulinism - prevention & control
  • Hypoglycemia
  • Infant
  • Insulin
  • Insulin - adverse effects
  • Insulin - blood
  • Insulin - therapeutic use
  • Insulin Resistance
  • Insulin sensitivity
  • Intensive Care Units, Pediatric
  • Length of Stay
  • Male
  • Netherlands
  • Pediatric intensive care unit
  • Pediatrics
  • Prospective Studies
  • Respiratory Insufficiency - complications
  • Vertebrates: anatomy and physiology, studies on body, several organs or systems
ispartof: Nutrition (Burbank, Los Angeles County, Calif.), 2012, Vol.28 (1), p.25-29
description: Abstract Objective The objective of this study was to investigate the relations of baseline insulin/glucose ratio to the clinical course of critically ill children. Such information will provide insight into the pathophysiologic mechanisms leading to hyperglycemia and will optimize preventive and therapeutic measures for hyperglycemia in critically ill children. Methods Sixty-four consecutively admitted critically ill children with hyperglycemia, defined as a blood glucose level higher than 8 mmol/L (>145 mg/dL) and treated with insulin according to a glucose-control protocol, were included. Demographic data and clinical and laboratory parameters were collected. Insulin sensitivity was investigated by calculating the ratio of insulin to the blood glucose level just before the start of insulin administration. Results are expressed as median (range). Results Sixty-four children (24 girls) 7.0 y of age (0.3–16.9 y) with various diagnoses were included. A hyperinsulinemic response, indicated by an increased insulin/glucose ratio (>18 pmol/mmol), was seen in 55% of children. The durations of insulin therapy, mechanical ventilation, and pediatric intensive care unit length of stay in children with a hyperinsulinemic response were longer than in children with a hypoinsulinemic response. Conclusion Hyper- and hypoinsulinemic responses play a role in the occurrence of hyperglycemia in critically ill children. Each is associated with a particular clinical course after the initiation of insulin therapy. It would be worthwhile to further investigate if the insulinemic response to hyperglycemia, determined by the insulin/glucose ratio in combination with the type of organ dysfunction, could be used in clinical practice to determine the need for insulin therapy.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0899-9007
fulltext: fulltext
issn:
  • 0899-9007
  • 1873-1244
url: Link


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titleBaseline insulin/glucose ratio as a marker for the clinical course of hyperglycemic critically ill children treated with insulin
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creatorVerhoeven, Jennifer J., M.D ; Koenraads, Marianne, M.D ; Hop, Wim C.J., Ph.D ; Brand, Jeannette B., R.N ; van de Polder, Mirjam M., R.N ; Joosten, Koen F.M., Ph.D
creatorcontribVerhoeven, Jennifer J., M.D ; Koenraads, Marianne, M.D ; Hop, Wim C.J., Ph.D ; Brand, Jeannette B., R.N ; van de Polder, Mirjam M., R.N ; Joosten, Koen F.M., Ph.D
descriptionAbstract Objective The objective of this study was to investigate the relations of baseline insulin/glucose ratio to the clinical course of critically ill children. Such information will provide insight into the pathophysiologic mechanisms leading to hyperglycemia and will optimize preventive and therapeutic measures for hyperglycemia in critically ill children. Methods Sixty-four consecutively admitted critically ill children with hyperglycemia, defined as a blood glucose level higher than 8 mmol/L (>145 mg/dL) and treated with insulin according to a glucose-control protocol, were included. Demographic data and clinical and laboratory parameters were collected. Insulin sensitivity was investigated by calculating the ratio of insulin to the blood glucose level just before the start of insulin administration. Results are expressed as median (range). Results Sixty-four children (24 girls) 7.0 y of age (0.3–16.9 y) with various diagnoses were included. A hyperinsulinemic response, indicated by an increased insulin/glucose ratio (>18 pmol/mmol), was seen in 55% of children. The durations of insulin therapy, mechanical ventilation, and pediatric intensive care unit length of stay in children with a hyperinsulinemic response were longer than in children with a hypoinsulinemic response. Conclusion Hyper- and hypoinsulinemic responses play a role in the occurrence of hyperglycemia in critically ill children. Each is associated with a particular clinical course after the initiation of insulin therapy. It would be worthwhile to further investigate if the insulinemic response to hyperglycemia, determined by the insulin/glucose ratio in combination with the type of organ dysfunction, could be used in clinical practice to determine the need for insulin therapy.
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subjectAdolescent ; Algorithms ; Biological and medical sciences ; Biomarkers - blood ; Blood Glucose - analysis ; Child ; Child, Preschool ; Children & youth ; Critical illness ; Dextrose ; Diabetes ; Drug Monitoring ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Gastroenterology and Hepatology ; Glucose ; Hospitals, Pediatric ; Hospitals, University ; Humans ; Hyperglycemia ; Hyperglycemia - complications ; Hyperglycemia - drug therapy ; Hyperglycemia - etiology ; Hyperglycemia - metabolism ; Hyperinsulinism - etiology ; Hyperinsulinism - prevention & control ; Hypoglycemia ; Infant ; Insulin ; Insulin - adverse effects ; Insulin - blood ; Insulin - therapeutic use ; Insulin Resistance ; Insulin sensitivity ; Intensive Care Units, Pediatric ; Length of Stay ; Male ; Netherlands ; Pediatric intensive care unit ; Pediatrics ; Prospective Studies ; Respiratory Insufficiency - complications ; Vertebrates: anatomy and physiology, studies on body, several organs or systems
ispartofNutrition (Burbank, Los Angeles County, Calif.), 2012, Vol.28 (1), p.25-29
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descriptionAbstract Objective The objective of this study was to investigate the relations of baseline insulin/glucose ratio to the clinical course of critically ill children. Such information will provide insight into the pathophysiologic mechanisms leading to hyperglycemia and will optimize preventive and therapeutic measures for hyperglycemia in critically ill children. Methods Sixty-four consecutively admitted critically ill children with hyperglycemia, defined as a blood glucose level higher than 8 mmol/L (>145 mg/dL) and treated with insulin according to a glucose-control protocol, were included. Demographic data and clinical and laboratory parameters were collected. Insulin sensitivity was investigated by calculating the ratio of insulin to the blood glucose level just before the start of insulin administration. Results are expressed as median (range). Results Sixty-four children (24 girls) 7.0 y of age (0.3–16.9 y) with various diagnoses were included. A hyperinsulinemic response, indicated by an increased insulin/glucose ratio (>18 pmol/mmol), was seen in 55% of children. The durations of insulin therapy, mechanical ventilation, and pediatric intensive care unit length of stay in children with a hyperinsulinemic response were longer than in children with a hypoinsulinemic response. Conclusion Hyper- and hypoinsulinemic responses play a role in the occurrence of hyperglycemia in critically ill children. Each is associated with a particular clinical course after the initiation of insulin therapy. It would be worthwhile to further investigate if the insulinemic response to hyperglycemia, determined by the insulin/glucose ratio in combination with the type of organ dysfunction, could be used in clinical practice to determine the need for insulin therapy.
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titleBaseline insulin/glucose ratio as a marker for the clinical course of hyperglycemic critically ill children treated with insulin
authorVerhoeven, Jennifer J., M.D ; Koenraads, Marianne, M.D ; Hop, Wim C.J., Ph.D ; Brand, Jeannette B., R.N ; van de Polder, Mirjam M., R.N ; Joosten, Koen F.M., Ph.D
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5Child
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9Dextrose
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11Drug Monitoring
12Feeding. Feeding behavior
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17Hospitals, Pediatric
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abstractAbstract Objective The objective of this study was to investigate the relations of baseline insulin/glucose ratio to the clinical course of critically ill children. Such information will provide insight into the pathophysiologic mechanisms leading to hyperglycemia and will optimize preventive and therapeutic measures for hyperglycemia in critically ill children. Methods Sixty-four consecutively admitted critically ill children with hyperglycemia, defined as a blood glucose level higher than 8 mmol/L (>145 mg/dL) and treated with insulin according to a glucose-control protocol, were included. Demographic data and clinical and laboratory parameters were collected. Insulin sensitivity was investigated by calculating the ratio of insulin to the blood glucose level just before the start of insulin administration. Results are expressed as median (range). Results Sixty-four children (24 girls) 7.0 y of age (0.3–16.9 y) with various diagnoses were included. A hyperinsulinemic response, indicated by an increased insulin/glucose ratio (>18 pmol/mmol), was seen in 55% of children. The durations of insulin therapy, mechanical ventilation, and pediatric intensive care unit length of stay in children with a hyperinsulinemic response were longer than in children with a hypoinsulinemic response. Conclusion Hyper- and hypoinsulinemic responses play a role in the occurrence of hyperglycemia in critically ill children. Each is associated with a particular clinical course after the initiation of insulin therapy. It would be worthwhile to further investigate if the insulinemic response to hyperglycemia, determined by the insulin/glucose ratio in combination with the type of organ dysfunction, could be used in clinical practice to determine the need for insulin therapy.
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pubElsevier Inc
pmid21820870
doi10.1016/j.nut.2011.04.005