Related Experiment Video

Updated: Jun 16, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

Clinical benefits of tight glycaemic control: effect on the kidney

Jan Gunst1, Miet Schetz

  • 1Department and Laboratory of Intensive Care Medicine, University of Leuven, Herestraat 49, 8-3000 Leuven, Belgium. jan.gunst@med.kuleuven.be

Best Practice & Research. Clinical Anaesthesiology
|January 30, 2010
PubMed

Insights

Tight glycemic control may help prevent acute kidney injury in critically ill patients. However, conflicting study results suggest optimal blood glucose targets for renoprotection require further definition.

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Endocrinology

Background:

  • Acute kidney injury (AKI) is a common, severe complication in critically ill patients.
  • Preventing AKI is a major clinical challenge.
  • Previous studies suggested tight glycemic control might reduce AKI, particularly in surgical patients.

Purpose of the Study:

  • To explore the potential renoprotective effects of tight glycemic control in critical illness.
  • To reconcile conflicting findings from previous randomized trials on glycemic control and AKI.
  • To identify potential mechanisms for glycemic control's impact on kidney protection.

Main Methods:

  • Review of randomized controlled trials (RCTs) in critically ill patients examining glycemic control and AKI.
  • Analysis of methodological differences between studies with conflicting results.
  • Exploration of proposed biological mechanisms for renoprotection.

Main Results:

  • Initial RCTs suggested a benefit of tight glycemic control in reducing AKI.
  • Subsequent RCTs failed to confirm this renoprotective effect.
  • Discrepancies are attributed to differences in patient populations, study size, control groups, glucose monitoring accuracy, and glycemic target achievement.

Conclusions:

  • The optimal glycemic target for preventing AKI in critical illness is not yet established.
  • Methodological heterogeneity in trials complicates definitive conclusions.
  • Potential mechanisms include preventing glucose toxicity, reducing inflammation/apoptosis, improving endothelial function, and lipid profiles.

More Related Videos

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes07:22

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Published on: March 7, 2025

Related Concept Videos

Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
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: Symptoms, Diagnosis, and Complications01:15

Diabetes: 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...
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...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...