Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis.
Endocr Pract. 2012 Jan 31;:1-17
Authors: Drake TC, Rudser KD, Seaquist ER, Saeed A
Objective: To investigate the effects of intravenous chromium on serum glucose and insulin infusion rates in hospitalized patients with severe insulin resistance.Methods: Hospital records from 01/01/08 - 12/01/10 were reviewed to identify patients for whom intravenous chromium was ordered at our academic medical center. To be included, patients were required to demonstrate profound insulin resistance and uncontrolled hyperglycemia (defined as the inability to achieve a blood glucose value <200 mg/dl during the 12 hours before chromium was given despite administration of continuous insulin infusion at a rate ?20 units/hr) and to have received a continuous infusion of chromium chloride at 20 mcg/hr for 10-15 hours for a total dose of 200-240 mcg.Results: Fourteen patients met our criteria. Over the hour preceding intravenous chromium, the mean ± SD rate of insulin infusion was 31 ± 15 units/hr and blood glucose was 326 ± 86 mg/dl. 12 hours after the initiation of chromium, these values were 16 ± 16 units/hr and 162 ± 76 mg/dl, respectively (p=0.011 difference in mean insulin rate from baseline, p<0.001 difference in mean blood glucose from baseline) and 24 hours after these values were 12 ± 15 units/hr and 144 ± 48 mg/dl, respectively (p<0.001 for both).Conclusions: Intravenous chromium decreased insulin needs and improved glucose control at 12 and 24 hrs compared to baseline values. Chromium appears to improve hyperglycemia and insulin resistance in acutely ill patients and represents a potential new therapy, with future prospective randomized controlled studies needed to confirm these results.
PMID: 22297054 [PubMed - as supplied by publisher]