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Related Experiment Videos

Stress-induced hyperglycemia.

K C McCowen1, A Malhotra, B R Bistrian

  • 1Departments of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. KMcCowen@caregroup.harvard.edu

Critical Care Clinics
|February 24, 2001
PubMed
Summary

Stress hyperglycemia in critically ill patients can lead to complications similar to diabetes. Controlling blood glucose levels with insulin is recommended to improve patient outcomes.

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Area of Science:

  • Critical care medicine
  • Endocrinology
  • Metabolic disorders

Background:

  • Stress hyperglycemia is a frequent complication in critically ill patients.
  • It shares potential complications with diabetes mellitus, including impaired wound healing and increased infection risk.
  • Counterregulatory hormones, cytokines, and dextrose administration (e.g., TPN) are primary contributors.

Purpose of the Study:

  • To highlight the clinical significance of stress hyperglycemia.
  • To emphasize the need for further research into its management.
  • To describe current institutional practices for managing stress hyperglycemia.

Main Methods:

  • Review of the pathophysiology and complications of stress hyperglycemia.
  • Discussion of the limited existing randomized data on glycemic control in hospitalized patients.
  • Description of the authors' institutional approach to insulin therapy for stress hyperglycemia.

Main Results:

  • Stress hyperglycemia is associated with significant complications.
  • Robust randomized controlled trial data supporting glycemic control are limited.
  • Prospective trials are needed to establish optimal management strategies.

Conclusions:

  • Stress hyperglycemia poses significant risks to critically ill patients.
  • Further research, including prospective controlled trials, is essential.
  • Interim management involves insulin to maintain plasma glucose between 150-200 mg/dL.

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