In the United States there are 6 million Intensive Care Unit (ICU) admissions per year. These ICU patients consume 15% of the one trillion dollars spent annually on hospitalized patients, or around 150 billion dollars per year! The average cost to care for an ICU patient is at least double that of a patient who never has to go to the ICU. When patients are admitted to an ICU they are extremely ill, which causes all of their stress hormones to be increased. These elevated stress hormone levels serve to counteract the glucose lowering properties of insulin, thus causing the ICU patients to have elevated blood glucose levels. Studies have shown that elevated blood glucose levels in ICU patients increases their morbidity and mortality rates, with this being true whether or not the patient has diabetes. Studies have also shown that effective glucose control, by lowering complication rates and shortening the hospital length of stay, can produce net cost savings of $1,500 to $4,000 per ICU patient. In addition, the mortality rates can be lowered by at least 20%. Given pre-pandemic overall ICU mortality rates of 10%, and the COVID-19 ICU mortality rate of 40%, safe and effective glucose control in the ICU setting has the potential to save at least 10 billion dollars and 100,000 lives on an annual basis in the U.S. Given the projected increase in total healthcare expenditures to 18 percent of the GDP by 2027 (see graph), it is important to begin to utilize treatment modalities that produce both net savings and improved healthcare outcomes.
National Health expenditures as a percent of GDP - from February 2019 CMS data and compiled by PGPF