Glycemic control in non-diabetic critically ill patients

Best Pract Res Clin Endocrinol Metab. 2011 Oct;25(5):813-24. doi: 10.1016/j.beem.2011.05.004.

Abstract

Hyperglycemia is a common and costly health care problem in hospitalized patients. In hospital hyperglycemia is defined as any glucose value >7.8 mmol/l (140 mg/dl). Hyperglycemia is present in 40% of critically ill patients and in up to 80% of patients after cardiac surgery, with ∼ 80% of ICU patients with hyperglycemia having no history of diabetes prior to admission. The risk of hospital complications relates to the severity of hyperglycemia, with a higher risk observed in patients without a history of diabetes compared to those with known diabetes. Improvement in glycemic control reduces hospital complications and mortality; however, the ideal glycemic target has not been determined. A target glucose level between 7.8 and 10.0 mmol/l (140 and 180 mg/dl) is recommended for the majority of ICU patients. This review aims to present updated recommendations for the inpatient management of hyperglycemia in critically ill patients with and without a history of diabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Critical Care / trends
  • Critical Illness / therapy*
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / drug therapy
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / complications
  • Hypoglycemia / etiology
  • Hypoglycemia / prevention & control*
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Insulin / adverse effects
  • Insulin / therapeutic use

Substances

  • Hypoglycemic Agents
  • Insulin