Diabetes Case Reports

Use of Variable rate Insulin Infusion (VRII) in ITU - Audit

22^nd Global Conference on Diabetes, Endocrinology and Primary Healthcare

May 30-31, 2024 | Amsterdam, Netherlands

Kadambari Tyagi , (MBBS) Muhammad Hamza Ansari , (MBBS, MRCP UK)

Scientific Tracks Abstracts: J Psychiatry

Abstract:

VRII is used in patients who are either unable to take oral food/fluid and adjustment of their own insulin regime is not possible, nil by mouth or severely ill. A retrospective audit of 51 ITU patients over 6 months was carried out regarding VRII prescription and monitoring requirements [1] in ITU setting of a tertiary care hospital to check if the requirements of VRII prescription/monitoring were being met. Results: 65% patients were not previously known diabetics; 35% were known diabetics of which 17% were T1DM and 83% were T2DM. 25% patients were on oral hypoglycaemic agents prior to ITU admission and of those only 54% had their OHAs paused when on VRII. All T1DM patients were on basal insulin prior to admission, only 67% had their basal insulin prescribed on VRII. Only 2% patients had hourly blood glucose monitoring on VRII. 10% patients had at least one hypoglycaemic event on VRII. Only 22% patients had their HbA1c checked during the admission and only 33% patients were referred to the diabetes team. Conclusions: 65% of non-diabetic patients required VRII highlighting the undiagnosed diabetes in community, and the impact of stress hyperglycaemia in ITU, giving importance to having HbA1c done on admission to ITU. The pausing of OHAs and prescription of basal insulin for T1DM was being missed. Lack of regular monitoring corresponded to hypoglycaemia events. To address these issues, there is a need for a local/national guideline for VRII in ITU patients. References : [1] Stella George et al (2015) – A guideline for the use of VRII in medical inpatients

Biography :

Muammad Hamza Ansari in an intermal medicine trainee year 3 currently working at University Hospitals Birmingham, UK. He is a member of Royal College of Physicians London. He is starting his Specialist Training in Endocrinology and Diabetes at West Midlands, UK from August 2024. Dr Kadambari Tyagi has completed her MBBS at the age of 26 years from CCS University in India. She is currently working as a Junior Specialist Doctor in Birmingham in Critical Care unit