Intensive Insulin Therapy in Elderly Patients with Acute Respiratory Infection

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  • 高齢者の呼吸器感染症治療における強化インスリン療法の効果
  • コウレイシャ ノ コキュウキ カンセンショウ チリョウ ニ オケル キョウカ インスリン リョウホウ ノ コウカ

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We evaluated the effects of strict glycemic control on the treatment of acute respiratory infections (pneumonia or acute bronchitis) in elderly (≥70 years old) patients. From January to June 2002 (Intervention year), 79 patients were enrolled in the study. Forty-three patients with hyperglycemia (≥130 mg/dl) received intensive insulin therapy. The treatment resulted in a significant reduction of the blood glucose level (from 193.6±63.5 to 102.6±20.9 mg/dl, p<0.01). We compared the data from the intervention year with those of the 84 patients in the observation year (January to June 2001). In the observation year, the mortality and complication rates were comparable between patients with and without hyperglycemia. However, the duration of fever and the duration of antibiotic administration tended to be longer in the hyperglycemic group than in the normoglycemic group. Furthermore, the duration of hospitalization was significantly longer in the hyperglycemic group than in the normoglycemic group (31.1±22.3 vs. 21.2±15.4 days, p<0.05). In the intervention year also, the mortality and complication rates were not significantly different between the normoglycemic group and the intensive insulin treatment group. The duration of fever and duration of antibiotic administration were also comparable between the two groups. The duration of hospitalization in the intensive insulin treatment group was not significantly longer than that in the normoglycemic group (19.7±11.5 vs. 18.0±15.1 days, p=0.57). Our results suggest that intensive in sulin therapy can accelerate recovery from acute respiratory infections in elderly patients with hyperglycemia.

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