PP341 - GLUCOSAFE 2 - A NEW DECISION-SUPPORT SYSTEM FOR BLOOD GLUCOSE MANAGEMENT AND NUTRITION THERAPY: ITS EFFECT ON BLOOD GLUCOSE CONTROL IN CRITICALLY ILL PATIENTS
PP341
GLUCOSAFE 2 - A NEW DECISION-SUPPORT SYSTEM FOR BLOOD GLUCOSE MANAGEMENT AND NUTRITION THERAPY: ITS EFFECT ON BLOOD GLUCOSE CONTROL IN CRITICALLY ILL PATIENTS
U. Pielmeier1,*, A. De Watteville2,3,4, E. Balzani5, H. Wozniak2,6, S. Primmaz2,6, L. Quagliara2,4, S. Andreassen1, C. P. Heidegger2,6
1Department of Health Science and Technology, The Faculty of Medicine, CardioTech, Aalborg University, Aalborg, Denmark, 2Division of Intensive Care, Department of Acute Care Medicine, 3Clinical Nutrition, Division of Gastroenterology, Hepatology & Nutrition, 4Care Directorate, Geneva University Hospitals, Geneva, Switzerland, 5Interdepartimental Center of Medical Sciences, University of Trento, Trento, Italy, 6Department of anaesthesiology, pharmacology, intensive care and emergency medicine, Geneva University, Geneva, Switzerland
Rationale: Blood glucose (BG) control remains a challenge in the ICU. Glucosafe 2 (GS2) is a model-based decision‑support tool designed to achieve safe and effective BG control tied with tailored nutritional therapy. GS2 calculates individual insulin‑sensitivity and provides personalised recommendations for insulin dosing and nutrition. This randomized control trial evaluates safety and efficacy of GS2 compared with standard ICU care.
Methods: We analyzed longitudinal BG measurements from 142 randomized ICU patients (GS2 vs control), from randomisation to day 15. We compared overall relative (%) time‑in‑target (5.0–8.5 mmol/l) and events of mild (2.2- 3.2 mmol/l) or severe (≤ 2.2 mmol/l) hypoglycaemia and compared between groups using the Wilcoxon rank-sum test. The trajectory of BG over time was modelled using a linear mixed-effects model with fixed effects for treatment group, treatment day, and their interaction, and a random intercept per patient.
Results: Median relative time‑in‑target did not differ significantly (73.8% in GS2 vs. 70.8% in controls; p = 0.149). Mild hypoglycaemia occurred in 8 GS2 patients, of whom 5 episodes were temporally associated with a recommendation by GS2. In control group, mild hypoglycaemia occurred in 5 patients and severe hypoglycaemia in one patient. In the mixed-effects model, BG decreased significantly faster in the GS2 group than in controls (β = -0.041 mmol/L per day, 95% CI -0.061 to -0.020; p < 0.001), with no difference between groups at baseline (p = 0.994).
Conclusion: GS2 improves population‑averaged BG control in the ICU with a favorable safety profile compared with standard care. Further studies are needed to assess the impact of GS2 treatment on clinical outcomes in intensive care patients.
Disclosure of Interest: None declared