• Alexis P Poole, James Anstey, Rinaldo Bellomo, Vishwanath Biradar, Adam M Deane, Simon R Finfer, Mark E Finnis, Craig J French, Palash Kar, Peter S Kruger, Matthew J Maiden, Johan Mårtensson, Colin J McArthur, Shay P McGuinness, Paul J Secombe, Antony E Tobin, Andrew A Udy, and Glenn M Eastwood.
• Discipline of Acute Care Medicine, University of Adelaide, Australia; Department of Intensive Care, Royal Adelaide Hospital, Australia. Electronic address: Alex.Poole@sa.gov.au.
• Aust Crit Care. 2019 Sep 1; 32 (5): 361-365.

BackgroundApproximately 9000 patients with type-2 diabetes mellitus (T2DM) are admitted to an intensive care unit (ICU) in Australia and New Zealand annually. For these patients, recent exploratory data suggest that targeting a more liberal blood glucose range during ICU admission may be safe and potentially beneficial. However, the current approach to blood glucose management of patients with T2DM in Australia and New Zealand ICUs is not well described, and there is uncertainty about clinician equipoise for trials of liberal glycaemic control in these patients.AimThe aim is to describe self-reported blood glucose management in patients with T2DM by intensivists working in Australian and New Zealand ICUs and to establish whether equipoise exists for a trial of liberal versus standard glycaemic control in such patients.MethodAn online questionnaire of Australia and New Zealand intensivists conducted in July-September 2016.ResultsSeventy-one intensivists responded. Forty-five (63%) used a basic nomogram to titrate insulin. Sixty-six (93%) reported that insulin was commenced at blood glucose concentrations >10 mmol/L and titrated to achieve a blood glucose concentration between 6.0 and 10.0 mmol/L. A majority of respondents (75%) indicated that there was insufficient evidence to define optimal blood glucose targets in patients with T2DM, and 59 (83%) were prepared to enrol such patients in a clinical trial to evaluate a more liberal approach.ConclusionA majority of respondents were uncertain about the optimal blood glucose target range for patients with T2DM and would enrol such patients in a comparative trial of conventional versus liberal blood glucose control.Copyright © 2018 Australian College of Critical Care Nurses Ltd. All rights reserved.

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