Related Experiment Video
Updated: Jul 11, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Early glucose normalization does not improve outcome in the critically ill trauma population
Susanna Shin1, Rebecca C Britt, Scott F Reed
1Department of Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
The American Surgeon
|September 21, 2007
Summary
Strict glucose control in critically ill patients is vital. Early normalization of serum glucose in burn and trauma intensive care units did not significantly impact patient morbidity or mortality rates.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Trauma Surgery
Background:
- Strict control of serum glucose in critically ill patients is associated with reduced morbidity and mortality.
- Hyperglycemia in intensive care units (ICUs) is common and linked to adverse outcomes.
Purpose of the Study:
- To evaluate the impact of early glucose normalization on outcomes in a burn and trauma intensive care unit.
- To assess whether prompt glucose control mitigates risks associated with hyperglycemia in severely injured patients.
Main Methods:
- Retrospective study of 290 hyperglycemic patients (serum glucose ≥ 150 mg/dL) and 319 normoglycemic patients (serum glucose < 150 mg/dL).
- Comparison of outcomes between patients with early glucose normalization (within 24 hours) and late normalization (> 24 hours).
- Analysis included injury severity, operative interventions, infection rates, and mortality.
Main Results:
- Hyperglycemic patients had more severe injuries and higher rates of operative intervention, infection, and mortality.
- Early glucose normalization (n=125) versus late normalization (n=165) showed no significant difference in infection rates.
- Despite initial correlations between hyperglycemia and worse outcomes, early normalization did not alter morbidity or mortality.
- The early normalization cohort was younger, but injury severity was comparable to the late normalization group.
Conclusions:
- Hyperglycemia on admission in critically ill burn and trauma patients correlates with increased risk.
- Early normalization of serum glucose in this population did not demonstrate a significant effect on reducing morbidity or mortality.
- Further research may be needed to identify optimal glucose control strategies for specific critically ill patient groups.
Related Concept Videos
01:15Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:26Hypoglycemia
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
01:20Pathophysiology of Diabetes
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
01:27Glucose Transporters
Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
01:15Diabetes: Symptoms, Diagnosis, and Complications
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...