title: Application of a glycaemic control optimization programme in patients with stress hyperglycaemia.
abstract: BACKGROUND
  Stress-induced hyperglycaemia (SHG) can be observed in as high as 75% of critically ill patients, which can induce severe complications or adverse events. However, conventional intensive insulin therapy (CIIT) tends to induce hypoglycaemia and glucose variability.
  
  
  OBJECTIVE
  This study investigated the clinical effects of a blood glycaemic control optimization programme (BGCOP) in patients with stress hyperglycaemia post hepatobiliary or pancreatic surgery.
  
  
  METHODS
  This study is a randomized, controlled, prospective clinical observation.
  
  
  METHODS
  Eighty-six patients with postoperative SHG were randomly divided into a control and experimental groups. Participants in the control group underwent CIIT, while participants in the experimental group underwent blood glycaemic control optimization programme (BGCOP). A range of 7·8-10·0 mmol/L was designated as the target range for effective control of blood sugar. The validity index, adverse events and complications were compared between two groups.
  
  
  RESULTS
  Compared to participants treated with CIIT, participants treated with BGCOP reached the target range of blood sugar levels more quickly (p = 0·000). The high glycaemic index (p = 0·000), incidence of hypoglycaemia (p = 0·011), and other adverse events as well as the incidence of abdominal infection (p = 0·026), incision infection (p = 0·044), and lung infection (p = 0·047) were significantly lower in participants who underwent the BGCOP than in patients treated with CIIT.
  
  
  CONCLUSIONS
  BGCOP can more effectively control blood sugar levels compared with CIIT in patients with SHG after hepatobiliary or pancreatic surgery.
  
  
  CONCLUSIONS
  This study provides a direction for blood glycaemic control in patients with stress hyperglycaemia post hepatobiliary or pancreatic surgery.
authors.affiliation: Surgical Intensive Care Unit, People's Hospital of Hunan Province, Changsha, Hunan, China.|Central South University School of Nursing, Changsha, Hunan, China.
authors.forename: Zeya
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Cummunity Nursing, Central South University School of Nursing, Changsha, Hunan, China.
authors.forename: Siyuan
authors.initials: S
authors.lastname: Tang
authors.affiliation: Department of Pharmacy, Biomedical Engineering Institute, Central South University, Changsha, Hunan, China.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Diana T-F
authors.initials: DT
authors.lastname: Lee
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Sek Y
authors.initials: SY
authors.lastname: Chair
authors.affiliation: Hepatobiliary Surgery, People's Hospital of Hunan Province, Changsha, Hunan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Surgical Intensive Care Unit, People's Hospital of Hunan Province, Changsha, Hunan, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Surgical Intensive Care Unit, People's Hospital of Hunan Province, Changsha, Hunan, China.
authors.forename: Xiaoji
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Nursing, College of Medicine, Luohe, China.
authors.forename: Jinxu
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Nursing, People's Hospital of Hunan Province, Changsha, Hunan, China.
authors.forename: Yuelan
authors.initials: Y
authors.lastname: Qin
mesh_terms: D001786:Blood Glucose; D064648:Critical Care Nursing; D016638:Critical Illness; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy*; D007003:Hypoglycemia / Q000209:etiology; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000009:adverse effects
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Advanced practice in ICU; Critical care nursing; Research