{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:27:57Z","timestamp":1782818877044,"version":"3.54.5"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>Background: Emerging evidence describes the high incidence and strong impact of hyperglycemia on the outcomes of critically ill patients with a diagnosis of COVID-19. Given resource limitations during the COVID-19 pandemic, clinicians moved away from using continuous IV infusions of insulin to manage hyperglycemia.\nObjective: To evaluate glycemic control in critically ill patients receiving various medication regimens to manage their hyperglycemia.Methods: This retrospective cohort study involved 120 mechanically ventilated adult patients (&gt; 18 years) with COVID-19 who were admitted to the intensive care unit (ICU) between February 2020 and December 2021. The following data were collected for the first 14 days of the ICU admission: blood glucose values (up to 4 times daily), hypoglycemia events, and antihyperglycemic medication regimens.\nResults: The use of IV insulin infusions maintained glucose measurements within the target range of 4 to 10 mmol\/L more often than any other medication regimen, with 60% of measured values falling within the target range. The use of a sliding-scale insulin regimen maintained 52% of glucose measurements within the target range. Oral hypoglycemic agents performed relatively poorly, with only 12% to 29% of glucose measurements within range. The coadministration of corticosteroids led to worse glycemic control across all medication regimens.\nConclusions: This study confirmed that ICUs should continue using the standard protocol of IV insulin infusion to achieve recommended blood glucose targets in critically ill patients with COVID-19, particularly those receiving corticosteroids.\nKeywords: critical care, intensive care, diabetes mellitus, glycemic control, COVID-19\nR\u00c9SUM\u00c9\nContexte : Des donn\u00e9es probantes \u00e9mergentes font \u00e9tat de l\u2019incidence \u00e9lev\u00e9e et des fortes r\u00e9percussions de l\u2019hyperglyc\u00e9mie sur les r\u00e9sultats des patients gravement malades ayant re\u00e7u un diagnostic de COVID-19. Vu les ressources restreintes pendant la pand\u00e9mie de COVID-19, les cliniciens se sont \u00e9loign\u00e9s de l\u2019utilisation des perfusions continues d\u2019insuline par IV pour g\u00e9rer l\u2019hyperglyc\u00e9mie.Objectif : \u00c9valuer le contr\u00f4le glyc\u00e9mique chez les patients gravement malades qui re\u00e7oivent divers r\u00e9gimes m\u00e9dicamenteux pour g\u00e9rer leur hyperglyc\u00e9mie.\nM\u00e9thodologie : Cette \u00e9tude de cohorte r\u00e9trospective portait sur 120 patients adultes (&gt; 18 ans) atteints de la COVID-19 ventil\u00e9s m\u00e9caniquement ayant \u00e9t\u00e9 admis \u00e0 une unit\u00e9 de soins intensifs entre f\u00e9vrier 2020 et d\u00e9cembre 2021. Les donn\u00e9es suivantes ont \u00e9t\u00e9 recueillies pendant les 14 premiers jours de l\u2019admission en USI : valeurs glyc\u00e9miques (jusqu\u2019\u00e0 4 fois par jour), \u00e9v\u00e9nements d\u2019hypoglyc\u00e9mie et r\u00e9gimes de m\u00e9dicaments antihyperglyc\u00e9miants.\nR\u00e9sultats : L\u2019utilisation de perfusions d\u2019insuline par intraveineuse permettait de maintenir les mesures de glucose dans la plage cible de 4 \u00e0 10 mmol\/L plus souvent que tout autre sch\u00e9ma th\u00e9rapeutique, avec 60 % des mesures se situant dans la plage cible. L\u2019utilisation d\u2019un sch\u00e9ma th\u00e9rapeutique \u00e0 insuline \u00e0 \u00e9chelle mobile a permis de maintenir 52 % des mesures de glucose dans la plage cible. Les r\u00e9sultats des hypoglyc\u00e9miants oraux \u00e9taient relativement mauvais, avec seulement 12 % \u00e0 29 % des mesures de glucose se situant dans la plage cible. L\u2019administration concomitante de corticost\u00e9ro\u00efdes a entra\u00een\u00e9 un moins bon contr\u00f4le glyc\u00e9mique dans tous les sch\u00e9mas th\u00e9rapeutiques.\nConclusions : Cette \u00e9tude a confirm\u00e9 que les unit\u00e9s de soins intensifs devraient continuer \u00e0 utiliser le protocole standard de perfusion d\u2019insuline par IV pour atteindre les objectifs de glyc\u00e9mie recommand\u00e9s chez les patients gravement malades atteints de la COVID-19, en particulier ceux recevant des corticost\u00e9ro\u00efdes.\nMots-cl\u00e9s : soins critiques, soins intensifs, diab\u00e8te, contr\u00f4le glyc\u00e9mique, COVID-19<\/jats:p>","DOI":"10.4212\/cjhp.3553","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T17:02:55Z","timestamp":1728493375000},"source":"Crossref","is-referenced-by-count":1,"title":["Glycemic Management in Patients with COVID-19 Admitted to the Intensive Care Unit: Evaluation of Glycemic Control and Drug Therapy"],"prefix":"10.4212","volume":"77","author":[{"given":"Emily","family":"Blacklaws","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Stabler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2732","published-online":{"date-parts":[[2024,10,9]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3553\/5434","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3553\/5435","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3553\/5434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T17:02:55Z","timestamp":1728493375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,9]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,10,9]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3553","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2024,10,9]]}}}