Dr. Francisco Ibarra Publishes Journal Article About the Safety and Effectiveness of Standardized Intravenous Insulin Infusion Order Set

July 20, 2023

Congratulations to Francisco Ibarra, Jr., PharmD, BCCCP, from the Department of Pharmacy Services at Community Regional Medical Center and faculty at the California Health Sciences University College of Osteopathic Medicine, for his recent publication titled, “Safety and Effectiveness of a Standardized Intravenous Insulin Infusion Order Set for Managing Uncontrolled Hyperglycemia Outside the Intensive Care Unit.”

Francisco Ibarra, Jr., PharmD, BCCCP
Adjunct Assistant Professor of Biomedical Education

The objective of Dr. Ibarra’s publication was to determine the effectiveness and safety of his institution’s non-critical care IV insulin infusion order set because few studies have evaluated the administration of intravenous (IV) insulin infusions for uncontrolled hyperglycemia in non-intensive care unit (ICU) patients, and there is inadequate data to guide how to appropriately administer IV insulin infusions to this patient population.

Dr. Ibarra’s retrospective study was conducted at two institutions within a health care system and included patients that were 18 years of age or older and received the noncritical care IV insulin infusion order set outside of the ICU.

The primary outcome was the number of individuals who achieved a glucose level ≤180 mg/dL. For those patients meeting this endpoint, the time to achieving this outcome and the percentage of glucose checks within the goal range were determined. The primary safety endpoint was the number of individuals who experienced hypoglycemia (glucose level <70 mg/dL).

The results of Dr. Ibarra’s study showed that twenty-one (84%) patients achieved a glucose level ≤180 mg/dL. The median (inter-quartile range [IQR]) time to achieving the primary outcome was 5.7 hours (3.9-8.3). In patients who achieved the primary outcome, 41.8% of the glucose readings obtained after achieving this outcome were within goal range. Two (8%) patients experienced hypoglycemia. Both of these events occurred within 8 hours of therapy initiation and neither patient received prior doses of subcutaneous insulin. Of the 4 patients who did not achieve a glucose level ≤180 mg/dL, 2 received high-dose corticosteroids, and 3 achieved a glucose level between 181 and 200 mg/dL.

In conclusion, Dr. Ibarra’s study findings support the safe administration of IV insulin infusions to non-ICU patients when targeting a glucose range of 140 to 180 mg/dL and limiting the infusion duration.

Read the full journal article