title: Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis.
abstract: OBJECTIVE
  To investigate the effects of intravenous chromium on serum glucose and insulin infusion rates in hospitalized patients with severe insulin resistance.
  
  
  METHODS
  In this retrospective study, we reviewed hospital records from January 1, 2008, to December 1, 2008, to identify patients for whom intravenous chromium was ordered at our academic medical center. To be included, patients were required to demonstrate profound insulin resistance and uncontrolled hyperglycemia (defined as the inability to achieve a blood glucose value less than 200 mg/dL during the 12 hours before chromium was given despite administration of continuous insulin infusion at a rate of 20 or more units/h) and to have received a continuous infusion of chromium chloride at 20 mcg/h for 10 to 15 hours for a total dose of 200 to 240 mcg.
  
  
  RESULTS
  Fourteen patients met our inclusion criteria. Over the hour preceding intravenous chromium infusion, the mean ± standard deviation rate of insulin infusion was 31 ± 15 units/h, and blood glucose was 326 ± 86 mg/dL. Twelve hours after the initiation of chromium, these values were 16 ± 16 units/h and 162 ± 76 mg/dL, respectively (P = .011 for difference in mean insulin rate from baseline, P<.001 for difference in mean blood glucose from baseline) and 24 hours after, these values were 12 ± 15 units/h and 144 ± 48 mg/dL, respectively (P<.001 for both).
  
  
  CONCLUSIONS
  Intravenous chromium decreases insulin needs and improves glucose control at 12 and 24 hours compared with baseline values. Chromium appears to improve hyperglycemia and insulin resistance in acutely ill patients and represents a potential new therapy. Future prospective randomized controlled trials are needed to confirm these results.
authors.affiliation: Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota 55455, USA. drake120@umn.edu
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Drake
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Rudser
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Seaquist
authors.forename: Asad
authors.initials: A
authors.lastname: Saeed
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D002712:Chlorides / Q000008:administration & dosage; D002857:Chromium / Q000008:administration & dosage / Q000627:therapeutic use*; D017608:Chromium Compounds / Q000008:administration & dosage; D003422:Critical Care; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000819:agonists / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000819:agonists / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D002712:Chlorides; D017608:Chromium Compounds; D007004:Hypoglycemic Agents; D007328:Insulin; D002857:Chromium; C022990:chromic chloride