Impact of Intensive Insulin Therapy on Clinical Outcomes of Traumatic Brain Injury Patients with Pre-Existing Diabetes

To determine the effect of intensive insulin therapy on blood glucose control in diabetes patients with traumatic brain injury. From November 2021 to December 2023, 186 patients with diabetes combined with traumatic brain injury were randomly divided into a low target group (i.e. intensive insulin treatment, blood glucose target at 3.9–6.1 mmol/L) and a high target group (i.e. routine insulin treatment, blood glucose target at 6.1–11.1 mmol/L) according to random number table method. Demographic and clinical characteristics of patients were obtained, including age, gender, cause of injury, GCS score, in-hospital mortality, length of ICU stay, wound infection rate, and other data. Follow up data was captured at 90 days following trauma. There was no significant difference in mortality rate, length of hospital stay, and GOS score between the two groups of patients. The infection rate in the intensive insulin group was lower than that in the conventional treatment group, but the incidence of hypoglycemia was significantly increased (P < 0.05). Intensive insulin therapy can not improve the main outcomes (mortality and neurological function), therefore clinicians should be very cautious in promoting strict glycemic control with insulin. In contrast, loose blood glucose control may be more appropriate.