What question did this study set out to answer?

This research aims to evaluate glucose management practices and associated outcomes in ICU patients.

February 22, 2026Acta Anaesthesiologica Scandinavica2 citationsOpen Access

Glucose Management in the ICU : The Bi‐Centre GEM ‐ ICU Cohort Study

MGMilda Grigonyte‐DaraskevicieneCopenhagen University Hospital RERuben J. EckUniversity of Copenhagen MMMorten Hylander MøllerUniversity of Copenhagen

Key Points

This research aims to evaluate glucose management practices and associated outcomes in ICU patients.
Conducted a bi-centre, retrospective cohort study in two Danish ICUs.
Included acutely admitted adult patients from electronic health records.
Primary outcome: occurrence of hypoglycaemia (< 4 mmol/L).
Analyzed secondary outcomes including severe hypoglycaemia, hyperglycaemia, and mortality.
Observed hypoglycaemia in 21 patients (7.4%; 95% CI 4.6–11.0) and severe hypoglycaemia in 3 patients (1.1%; 95% CI 0.2–3.0).
Detected hyperglycaemia in 186 patients (65.3%; 95% CI 59.4–70.8).
30-day mortality was 24.3% (95% CI 19.6–29.6).
Median days alive without life support at 30 days was 27 days.
Patients receiving insulin spent nearly half the time above the target glucose range.

Abstract

ABSTRACT Introduction Dysglycaemia is common in intensive care unit (ICU) patients and has been associated with worse outcomes. Data on glucose management and insulin use from contemporary intensive care units (ICUs) are limited. Methods We conducted a bi‐centre, retrospective cohort study of acutely admitted, adult patients at two Danish ICUs. Patients were included consecutively by backtracking admissions from December 1, 2023, until the target sample size ( n = 300) was reached. Data were collected from electronic health records following a predefined protocol. The primary outcome was the occurrence of hypoglycaemia ( 10 mmol/L), time below blood glucose target range ( 10 mmol/L), mortality at 30 days, days alive without life support at 30 days (DAWOLS) and days alive out of hospital at 30 days (DAOH). Process variables were also assessed. Results We screened 311 ICU patients and included 300, of whom 285 had at least one blood glucose measurement. Hypoglycaemia was observed in 21 patients (7.4%; 95% CI 4.6–11.0) and severe hypoglycaemia in 3 patients (1.1%; 95% CI 0.2–3.0). Hyperglycaemia was observed in 186 patients (65.3%; 95% CI 59.4–70.8). Mortality at 30 days was 24.3% (95% CI 19.6–29.6). Median DAWOLS at 30 days was 27 days (95% CI 26–28; IQR 8–30) and median DAOH at 30 days was 9 days (95% CI 3–14; IQR 0–21). Conclusion In this Danish bi‐centre cohort of acutely admitted ICU patients, hypoglycaemia was uncommon and severe hypoglycaemia was rare, whereas hyperglycaemia occurred in almost every second patient. Insulin was frequently administered, mostly intravenously, and glucose was monitored often. Patients receiving insulin spent nearly half of the observed time above the target range. Editorial Comment In this retrospective analysis from 2 Danish centres, glucose management and insulin use in the ICU is presented. Rare hypoglycemia and more common hyperglycemia measurement events were counted, along with insulin administration, which was common.

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