Intensive Glycemic Control for Congestive Heart Failure Exacerbation

Patients with heart failure often have high blood sugar. High glucose contributes to severe
hospital complications and even death. Studies suggest that heart failure patients who have
high glucose or diabetes do not live as long as patients with normal glucose. In this study,
we will determine whether normalizing blood sugars using intravenous insulin short-term will
improve outcomes in patients hospitalized for congestive heart failure. We enrolled patients
with severe heart failure and randomly assigned them into 2 groups. We used intravenous
(given through the vein) insulin to lower blood sugar levels in group 1, and insulin
injections in group 2. We determined whether intravenous insulin improved hospital length of
stay, rates of readmission, inflammatory markers, and cardiovascular tests that predict
mortality in patients with heart failure.

Inclusion Criteria:

- Age 18 and above

- Admitted (less than 48 hours) to the OSU Ross Heart Hospital with worsening heart
failure

- Hyperglycemia or diabetes. Hyperglycemia is defined as blood glucose greater than 150
mg/dL on at least 2 occasions separated by at least 4 hours apart, insulin use, or
HbA1c >6.5%.

Exclusion Criteria:

- Type 1 diabetes

- Receiving comfort care measures only

- Hospital stay expected to be less than 2 days

- Pregnancy

- Prisoners

- Participation in the study on prior hospitalizations

- Acute myocardial infarction within 3 months

- End stage renal or liver disease