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Related Concept Videos

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...
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...
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...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
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...
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Acute Pancreatitis II: Clinical Manifestations and Management

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Updated: Jun 2, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Understanding glycemic control in the critically ill: 2011 update.

James S Krinsley1

  • 1Division of Critical Care, Stamford Hospital, Stamford, CT 06902, USA. jkrinsley@stamhealth.org

Hospital Practice (1995)
|May 18, 2011
PubMed
Summary

Intensive blood glucose monitoring in critically ill patients is standard care. This review covers hyperglycemia, hypoglycemia, glycemic variability, and diabetes impacts on outcomes.

Area of Science:

  • Critical care medicine
  • Endocrinology
  • Metabolic disorders

Background:

  • Intensive blood glucose monitoring is standard in ICUs.
  • Guidelines evolved from a single trial targeting postoperative euglycemia.
  • Understanding glucose control disturbances is crucial.

Purpose of the Study:

  • Summarize literature on hyperglycemia and mortality in critically ill patients.
  • Review major intensive insulin therapy trials.
  • Discuss hypoglycemia, glycemic variability, and diabetes impact.

Main Methods:

  • Literature review of studies on glycemic control in critically ill patients.
  • Analysis of interventional trials on intensive insulin therapy.
  • Framework for understanding dysglycemia presented.

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A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
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A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

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Last Updated: Jun 2, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

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

Main Results:

  • Hyperglycemia is linked to mortality in the critically ill.
  • Intensive insulin therapy trials show mixed results.
  • Hypoglycemia and glycemic variability correlate with adverse outcomes.

Conclusions:

  • Dysglycemia in critically ill patients involves hyperglycemia, hypoglycemia, and variability.
  • Implementing glycemic management protocols requires practical considerations.
  • Evidence supports a multi-domain approach to glucose control.