This is a companion article to the feature, “Glucose Testing in Hospital Environments.”

Studies headed by Anthony P. Furnary, MD, of St Vincent’s Hospital, Portland, Ore, led to the development of what is now referred to as the Portland Diabetes Protocols for tight glycemic control.

Beginning in 1987, the research team of the Portland Diabetes Project, based at Providence Heart and Vascular Institute, investigated the relationship between inpatient hyperglycemia (high blood glucose levels) and hospital outcomes in diabetic cardiac surgery patients. The team was one of the first to show that hyperglycemia was a significant causal factor for the increased risks of death, infection, and length of hospital stay in the diabetic patient population.

Conversely, the team was also the first to show that eliminating hyperglycemia through the use of intravenous insulin infusion for 3 perioperative days would eradicate the incremental increases in complications that were previously ascribed to the risk factor of diabetes.

The Portland Diabetes Protocols are a finely tuned set of orders for intravenous insulin infusions in hospitalized diabetic patients, for use in both intensive care units and on the wards. The protocols have been in use since 1992, and have been successfully used at institutions throughout the world to control hyperglycemia. Since that time, the protocols have been repeatedly modified and honed to provide what the researchers believe to be the tightest, most efficient, and safest tight glycemic control of any insulin protocol available.

For further information, visit the Portland Diabetes Protocols homepage at: