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Glycemic control in non-diabetic critically ill patients

Farnoosh Farrokhi1, Dawn Smiley, Guillermo E Umpierrez

  • 1Department of Medicine, Division of Endocrinology, Emory University School of Medicine, 49 Jesse Hill Jr Dr., Atlanta, GA 30303, USA. Farnoosh.farrokhi@emory.edu

Best Practice & Research. Clinical Endocrinology & Metabolism
|September 20, 2011
PubMed

Insights

Hospital hyperglycemia, or high blood glucose, affects many patients and increases risks. Current guidelines suggest targeting glucose levels between 7.8-10.0 mmol/l (140-180 mg/dl) for most ICU patients.

Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Hospital Medicine

Background:

  • Hyperglycemia is a prevalent and costly issue in hospitalized patients, affecting up to 80% post-cardiac surgery and 40% of critically ill individuals.
  • A significant proportion of intensive care unit (ICU) patients with hyperglycemia have no prior history of diabetes.
  • The severity of hyperglycemia correlates with increased hospital complications, particularly in patients without pre-existing diabetes.

Purpose of the Study:

  • To provide updated recommendations for managing hyperglycemia in critically ill patients.
  • To address glycemic control strategies for both diabetic and non-diabetic hospitalized patients.
  • To review the impact of glycemic control on hospital complications and mortality.

Main Methods:

  • This is a review article, synthesizing current evidence and guidelines.
  • It focuses on inpatient hyperglycemia management in critically ill populations.
  • Recommendations are based on established clinical practice and research findings.

Main Results:

  • Hyperglycemia is defined as a glucose level >7.8 mmol/l (140 mg/dl) in hospitalized patients.
  • Glycemic control improvement is linked to reduced complications and mortality.
  • A target glucose range of 7.8–10.0 mmol/l (140–180 mg/dl) is recommended for most ICU patients.

Conclusions:

  • Effective inpatient hyperglycemia management is crucial for improving patient outcomes.
  • Specific glycemic targets are recommended for critically ill patients, considering their diabetes history.
  • Further research may refine ideal glycemic targets in diverse hospitalized populations.

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