Nutrition in Clinical Practice

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Google Scholar
Right arrow Articles by Via, M.
Right arrow Articles by Mechanick, J. I.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Via, M.
Right arrow Articles by Mechanick, J. I.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Nutrition in Clinical Practice, Vol. 23, No. 3, 325-328 (2008)
DOI: 10.1177/0884533608318676

Clinical Observations

Chromium Infusion Reverses Extreme Insulin Resistance in a Cardiothoracic ICU Patient

Michael Via, MD, Corey Scurlock, MD, Jayashree Raikhelkar, MD, Gabriele Di Luozzo, MD and Jeffrey I. Mechanick, MD

From the Mount Sinai School of Medicine, New York.

Address correspondence to: Jeffrey I. Mechanick, MD, Mount Sinai School of Medicine, Endocrinology, Diabetes and Bone Disease, 1192 Park Ave, New York, NY 10128; e-mail: Jmechanick{at}aol.com.

Insulin resistance is common and often multifactorial in acutely critically ill patients. At our institution, glycemic control is achieved in these patients using an intravenous insulin protocol. The authors present a case in which a patient developed severe insulin resistance following surgical repair of a thoracic aorta aneurysm. Postoperatively, the patient required 2110 units of insulin over 40 hours while receiving pressors and glucocorticoids. After the administration of intravenous chromium at 3 µg/h, the blood sugar normalized and insulin therapy was discontinued. This case represents a unique approach using intravenous chromium to achieve glycemic control in a patient with extreme insulin resistance and acute critical illness. Prospective clinical trials using intravenous chromium may provide the means to optimize intensive insulin therapy for critically ill patients.

Key Words: chromium • insulin • critical illness • insulin resistance • hyperglycemia • glucose intolerance


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?