In a randomized trial, glucose control therapy determined with the aid of a computer program provided better efficacy outcomes than therapy based on nurses’ decisions.
A computer software program, known as LOGIC-Insulin, more effectively controlled blood glucose levels among critically ill patients than did nurse-directed care, according to study results presented at The Endocrine Society’s 94th Annual Meeting and Expo in Houston.
“Computer-directed algorithms, such as LOGIC-Insulin, that are approved by experts and clinically validated in large studies, will allow safe and effective blood-glucose control,” said study director Dieter Mesotten, MD, PhD, Assistant Professor at Catholic University Leuven in Belgium. “This is essential to improve the outcome of critically ill patients in general practice.”
In a single-blinded study, Mesotten and colleagues randomly assigned 300 critically ill patients to insulin titration determined by a team of expert nurses or to treatment based on the LOGIC-Insulin computer program. The goal was to maintain glucose levels between 80 and 110 mg/dL and to avoid severe hypoglycemia (< 40 mg/dL). The primary outcome measure was glucose control up to 14 days after study enrollment.
Patients’ average age was 63. About one-fifth of patients had diabetes and 60% were men. All patients had been admitted to the ICU after undergoing heart or other surgery or due to other serious medical complications. Baseline blood glucose was similar between the groups.
Patients in the LOGIC-Insulin group were less likely to develop hypoglycemia. They also spent more time within the study’s targeted glucose levels and exhibited a smaller difference between minimum and maximum blood glucose readings on a daily basis, indicating less glycemic variability.
According to Mesotten, the study results demonstrate the value of computer-assisted technology in controlling injury-related diabetes.
“The LOGIC-1 study is the first large, randomized, controlled clinical trial that has shown an improved blood-glucose control in comparison with expert nurses,” Mesotten said. “LOGIC-Insulin software improves the efficacy and safety of blood glucose control in a wide variety of critically ill patients, which may improve their outcome.”