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- Michael Via, Corey Scurlock, Jayashree Raikhelkar, Gabriele Di Luozzo, and Jeffrey I Mechanick.
- Mount Sinai School of Medicine, Endocrinology, New York, NY 10128, USA.
- Nutr Clin Pract. 2008 Jun 1; 23 (3): 325-8.
AbstractInsulin resistance is common and often multifactorial in acutely critically ill patients. At our institution, glycemic control is achieved in these patients using an intravenous insulin protocol. The authors present a case in which a patient developed severe insulin resistance following surgical repair of a thoracic aorta aneurysm. Postoperatively, the patient required 2110 units of insulin over 40 hours while receiving pressors and glucocorticoids. After the administration of intravenous chromium at 3 microg/h, the blood sugar normalized and insulin therapy was discontinued. This case represents a unique approach using intravenous chromium to achieve glycemic control in a patient with extreme insulin resistance and acute critical illness. Prospective clinical trials using intravenous chromium may provide the means to optimize intensive insulin therapy for critically ill patients.
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