Patients with chronic obstructive pulmonary disease (COPD) are commonly admitted to hospital with exacerbations of their lung disease. A combination of the acute illness and treatment with oral steroids causes a rise in blood sugar. Patients with high blood sugar do worse than those with normal blood sugar. The aim of this study is to develop a safe and effective protocol for tight control of blood glucose with insulin on acute medical wards outside the intensive care environment. This will allow us to perform a formal trial to determine whether blood glucose control with insulin reduces death and complications from COPD exacerbations.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Intravenous insulin (actrapid) Subcutaneous insulin (aspart, glargine, detemir)
St George's Healthcare NHS Trust
London, United Kingdom
The frequency of severe hypoglycaemia - Neuroglycopenic symptoms (other than mild agitation) responsive to administration of carbohydrate
Time frame: During trial
The frequency of symptomatic hypoglycaemia (capillary glucose≤3.3mM AND symptoms consistent with hypoglycaemia)
Time frame: During trial
The frequency of asymptomatic hypoglycaemia (capillary glucose≤3.3mM without any symptoms consistent with hypoglycaemia).
Time frame: During treatment
Mean 24 hour capillary glucose concentrations
Time frame: During treatment
Proportion of capillary glucose measurements in target range (4.4-6.5mM)
Time frame: During treatment
Comparison of capillary blood glucose measurements to those obtained from the Guardian REAL®-time continuous glucose monitoring system
Time frame: During monitoring
Comparison of rates of detection of hypoglycaemia by capillary and continuous blood glucose monitoring
Time frame: During monitoring
Quantification of acceptability of the study intervention to patients
Time frame: during study
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