Assessment of knowledge, attitudes and practices about tight glycemic control in the critically ill among endocrinologists and intensivists practicing in Chennai

Abstract

Background: Tight glycemic control in the critically ill is known to reduce both the morbidity and the mortality.It is essential that intensivists and endocrinologists involved in the care of these patients have a good understanding of the concepts related to this condition. Objectives: To assess the knowledge, attitudes and practices about achieving tight glycemic control in the critically ill among the endocrinologists and intensivists practicing in the city of Chennai. Materials and Methods: Questionnaires containing ten questions pertaining to clinical outcomes, drawbacks, target levels of glycemic control and insulin regimen in achieving tight glycemia in the critically ill were sent to a total of six endocrinologists and 52 intensivists practicing in Chennai.Results: All those who were administered the questionnaires responded. Majority of the responders (88%) believed in tight glycemic control in the critically ill because of better outcomes from hospitalization. A minority did not for fear of hypoglycemia. Fifty percent agreed on the cut off value of 110 mg/dL as followed in the Van den Berghe study. Seventy percent used glucometer for monitoring sugar levels. Most preferred using regular insulin as infusion. Conclusions: There seems to be a good understanding and standard practices among the endocrinologists and intensivists in achieving strict glycemic control in the critically ill. Setting up of standard intensive care unit glycemic control protocols will settle all the methodological differences and make the practices more uniform.

Knowledge, Attitude, and Practice towards Glycemic Control and Its Associated Factors among Diabetes Mellitus Patients

“…Studies have shown that significant reduction in the mortality and morbidity occurs with the improved glycemic control. This may be due to a reduction in microvascular complications like low systemic inflammation, by the prevention of immune dysfunction and protection of the endothelium and of the mitochondrial ultrastructure and function [9].…”