Advances in safe insulin infusions

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Hyperglycaemia is recognized as a marker of adverse clinical outcomes for hospitalized patients with and without diabetes, including mortality, morbidity, increased length of stay, infections and overall complications. In some cases, intravenous (IV) insulin infusions are the optimal intervention and, to date, these have been compounded in hospital pharmacy departments or, alternatively, at the point of care, when timeliness is a concern or the pharmacy is closed. However, in-house compounding of high-risk medications such as IV insulin poses risks both for patients and institutions. The critical nature of certain high-risk therapies has led to the development of ready-to-administer products to improve the safety, timeliness, efficacy and efficiency of critical infusions. Recently, IV insulin, a high-alert therapy, has been added to the ready-to-use armamentarium. This narrative review explores the expanding indications, risks and opportunities associated with insulin infusions and potential options for improved safety.

Keywords: insulin, insulin infusion, IV insulin, patient safety, Myxredlin.

Citation: Massoomi F, Burger M, de Vries C. Advances in safe insulin infusions. Drugs in Context 2021; 10: 2021-1-6. DOI: 10.7573/dic.2021-1-6

Contributions: FM and MB reviewed the literature, wrote portions of the manuscript and reviewed/edited/approved the full manuscript. CdV provided literature review and wrote a draft of the manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. Visante provides consulting services to companies including Baxter. The authors did not receive any direct compensation from Baxter. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at:

Acknowledgements: None.

Funding declaration: This paper did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Copyright: Copyright © 2021 Massoomi F, Burger M, de Vries C. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Massoomi F, Burger M, de Vries C. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

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Correspondence: Maureen Burger, Visante Inc., 7905 Morningside Dr, Indianapolis, IN 46240, USA. Email:

Provenance: Submitted; externally peer reviewed.

Submitted: 19 January 2021; Accepted: 9 June 2021; Publication date: 15 July 2021.

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