Investigators: Devan Kansagara, MD, Fawn Wolf, MD, Michele Freeman, MPH, and Mark Helfand, MD, MPH.
Portland Veterans Affairs Healthcare System, Oregon Evidence-based Center
Washington (DC): Department of Veterans Affairs; October 2008.
Download PDF: Complete Report, Executive Summary, Report, Appendices
Hyperglycemia is a common finding in hospitalized patients and has been associated with worsened outcomes in a variety of inpatient subpopulations. The use of insulin to control blood glucose has been advocated as a way to improve health outcomes in hospitalized patients with hyperglycemia, but the evidence for the efficacy of this approach and the thresholds for initiating insulin management are unclear.
The key questions were:
Synthesis of the Evidence on Inpatient Hyperglycemia Management Finds Intensive Insulin Therapy Does Not Clearly Improve Health Outcomes (VA HSR&D Management e-Brief) (76 KB, PDF)
Kansagara D, Fu R, Freeman M, Wolf F, Helfand M. Intensive insulin therapy in hospitalized patients: a systematic review. Ann Intern Med. 2011 Feb 15;154(4):268-282.