Stress hyperglycaemia

Lancet. 2009 May 23;373(9677):1798-807. doi: 10.1016/S0140-6736(09)60553-5.


Results of randomised controlled trials of tight glycaemic control in hospital inpatients might vary with population and disease state. Individualised therapy for different hospital inpatient populations and identification of patients at risk of hyperglycaemia might be needed. One risk factor that has received much attention is the presence of pre-existing diabetes. So-called stress hyperglycaemia is usually defined as hyperglycaemia resolving spontaneously after dissipation of acute illness. The term generally refers to patients without known diabetes, although patients with diabetes might also develop stress hyperglycaemia-a fact overlooked in many studies comparing hospital inpatients with or without diabetes. Investigators of several studies have suggested that patients with stress hyperglycaemia are at higher risk of adverse consequences than are those with pre-existing diabetes. We describe classification of stress hyperglycaemia, mechanisms of harm, and management strategies.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / complications
  • Critical Illness*
  • Early Diagnosis
  • Glucose Tolerance Test
  • Humans
  • Hyperglycemia* / diagnosis
  • Hyperglycemia* / epidemiology
  • Hyperglycemia* / etiology
  • Hyperglycemia* / prevention & control
  • Monitoring, Physiologic
  • Prediabetic State / complications
  • Prevalence
  • Research Design
  • Risk Factors
  • Risk Reduction Behavior
  • Severity of Illness Index
  • Stress, Physiological* / physiology
  • Stroke / complications
  • Surgical Procedures, Operative / adverse effects
  • Treatment Outcome


  • Blood Glucose