Press releases

Released January 29, 2004
Yale-New Haven Hospital news release

Yale-New Haven Hospital develops revolutionary treatment for critically ill patients

For more information, call 203-688-2493 or E-mail Mark D'Antonio

A new, revolutionary treatment involving the intravenous infusion of insulin for critically ill patients with hyperglycemia (high blood sugar) is being used in the medical intensive care unit (MICU) at Yale-New Haven Hospital (YNHH). Hyperglycemia occurs in the majority of critically ill patients, even in those without a clinical history of diabetes. In these patients, hyperglycemia increases the risk of complications and even death.

Based on emerging clinical evidence, lowering a patient’s blood sugar into the normal range reduces mortality, length of time spent in the ICU, bloodstream infections, possibility of kidney failure, and the need for prolonged use of a mechanical respirator. In diabetic patients, it even improves the long-term prognosis after an acute heart attack.

"Until now, achieving tight blood sugar control has been very difficult," said Silvio Inzucchi, M.D., clinical director of endocrinology, which includes the Yale Diabetes Center at Yale-New Haven Hospital. "Our insulin infusion protocol is a simplified, safe and effective algorithm designed specifically for use by ICU nurses. It provides specific hourly recommendations for insulin dosing in critically ill patients with a proven system for follow-up measurements and adjustments."

Dr. Inzucchi supervised the work of postdoctoral fellow Philip Goldberg, M.D., who developed the protocol, which was tested in the YNHH MICU. As part of their initial studies, the protocol was shown to be extraordinarily effective and safe, and determined to be easy to use by the nursing staff. After presenting their data at a national meeting of the American Diabetes Association, Drs. Inzucchi and Goldberg received more than 50 requests for copies of the protocol from around the world, including hospitals in India, the Philippines, Wales and Belgium.

"The implementation of any treatment protocol involves the careful cooperation between multiple services who are vested in providing improved patient outcomes," said Dr. Inzucchi. "Yale-New Haven Hospital is blessed with some of the best ICU nurses around and they did a beautiful job implementing our protocol. Mark Siegel, M.D., medical director of the MICU, was also a wonderful collaborator who had the vision to translate what was happening in research to the patients in this unit."

The Yale Insulin Infusion Protocol will appear in the February issue of Diabetes Care, produced by the American Diabetes Association.

Yale-New Haven Hospital is a 944-bed, not-for-profit hospital serving as the primary teaching hospital for the Yale School of Medicine. Yale-New Haven was founded as the fourth voluntary hospital in the U.S. in 1826 and today, the hospital complex includes Yale-New Haven Children's Hospital and Yale-New Haven Psychiatric Hospital, with a combined medical staff of about 2,400 university and community physicians practicing in more than 100 specialties.

Reporter: Katie Fischer, 203-688-2488.

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