Short acting insulin analogues in intensive care unit patients

Blood glucose control in intensive care unit (ICU) pa- tients, addressed to actively maintain blood glucose concentration within defined thresholds, is based on two major therapeutic interventions: to supply an ad- equate calories load and, when necessary, to continu- ously infuse insulin titrated to patients needs: intensive insulin therapy (IIT). Short acting insulin analogues (SAIA) have been synthesized to improve the chronic treatment of patients with diabetes but, because of the pharmacokinetic characteristics that include shorter on- set and off-set, they can be effectively used also in ICU patients and have the potential to be associated with a Bilotta F, Guerra C, Badenes R, Lolli S, Rosa G. Short acting insulin analogues in intensive care unit patients. World J Dia- betes 2014; 5(3): 000-000 Available from: URL: http://www. wjgnet.com/1948-9358/full/v5/i3/000.htm DOI: http://dx.doi. org/10.4239/wjd.v5.i3.000 more limited risk of inducing episodes of iatrogenic hy- poglycemia. Medical therapies carry an intrinsic risk for collateral effects; this can be more harmful in patients with unstable clinical conditions like ICU patients. To minimize these risks, the use of short acting drugs in ICU patients have gained a progressively larger room in ICU and now pharmaceutical companies and research- ers design drugs dedicated to this subset of medical practice. In this article we report the rationale of using short acting drugs in ICU patients (i.e. , sedation and treatment of arterial hypertension) and we also de- scribe SAIA and their therapeutic use in ICU with the potential to minimize iatrogenic hypoglycemia related