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Related Concept Videos

Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Hypoglycemia and Glucagon01:15

Hypoglycemia 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...
Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are co-secreted in...
Hyperglycemia01:29

Hyperglycemia

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...
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

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Related Experiment Video

Updated: Jun 24, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Glucose control in the intensive care unit.

Brenda G Fahy1, Ann M Sheehy, Douglas B Coursin

  • 1Department of Anesthesiology, University of Kentucky Chandler Medical Center, Lexington, KY, USA.

Critical Care Medicine
|March 28, 2009
PubMed
Summary

Hyperglycemia is common in critically ill patients and affects outcomes, especially in those with stress-induced hyperglycemia. While intensive insulin therapy is proposed, evidence for tight glycemic control (TGC) remains conflicting, necessitating further research.

Related Experiment Videos

Last Updated: Jun 24, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Metabolic Disorders

Background:

  • Hyperglycemia is prevalent in critically ill patients, stemming from diabetes, impaired glucose tolerance, or stress.
  • Glucose variability and hyperglycemia in intensive care units (ICUs) prompt debate on intensive insulin therapy for glycemic control.
  • Concerns exist regarding optimal glucose targets, measurement accuracy, resource allocation, and the impact of tight glycemic control (TGC) across diverse ICU populations.

Purpose of the Study:

  • To review the epidemiology and glucose metabolism in critically ill patients.
  • To discuss current limitations in glucose monitoring and management approaches in the ICU.
  • To provide insights into the transition of glycemic care from ICU to lower care settings and future developments.

Main Methods:

  • Literature search of PubMed and Cochrane Analysis for studies post-2000, focusing on hyperglycemia and glycemic control in critically ill patients.
  • Review of recent meta-analyses and expert opinions.
  • Investigation of the Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial website.

Main Results:

  • Hyperglycemia is common in critically ill patients, negatively impacting outcomes, particularly in those with stress-induced hyperglycemia.
  • The incidence of hypoglycemia associated with TGC can be significant (up to 18.7%), with particular concern in patients with septic shock or neurologic compromise.
  • Increased glucose variability during critical illness and its therapeutic management may have a detrimental effect on survival.

Conclusions:

  • Hyperglycemia significantly impacts outcomes in critically ill patients, especially those with stress-induced hyperglycemia.
  • Despite expert recommendations for TGC, supporting data are incomplete and conflicting.
  • The NICE-SUGAR study is expected to provide crucial data to guide future best practices in adult glycemic management.