Implementation of a tight glycaemic control protocol using a web‐based insulin dose calculator

Summary We describe the implementation of a glucose control protocol supported by a web-based insulin dose calculator in a 16-bedded intensive care unit. The protocol was introduced and then modified after 15 months' use. Glucose concentrations were retrospectively reviewed and compared for the 9-month period before introduction of the protocol (288 patients), for 15 months after its introduction (502 patients) and for a further 5 months after its modification to increase insulin dose (101 patients). The mean (SD) blood glucose concentrations decreased from 7.3 (1.8) mmol.l−1 to 6.6 (1.6) mmol.l−1 and then to 6.2 (1.3) mmol.l−1. The proportion of values  8.0 mmol.l−1 was 2.10 [1.19–3.73] compared to values < 6.1 mmol.l−1. However, patient mortality remained constant during the study. Glycaemic control was improved outside a research setting using a protocol supported by a web-based insulin dose calculator.