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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...
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...
Hormones Regulating Blood Glucose01:16

Hormones Regulating Blood Glucose

Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
In addition to accelerating glucose uptake and utilization, insulin has...
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...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...

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Updated: May 17, 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.

Jean-Charles Preiser1

  • 1Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

World Review of Nutrition and Dietetics
|October 19, 2012
PubMed
Summary
This summary is machine-generated.

Stress hyperglycemia in critically ill patients impacts outcomes. While intensive insulin therapy initially showed survival benefits, subsequent studies revealed discrepancies due to factors like nutrition and glucose variability, necessitating further research.

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Metabolic Regulation

Background:

  • Stress-related hyperglycemia is prevalent in acutely ill patients, correlating with illness severity and prognosis.
  • Pathophysiology involves hormonal/neural signals, increased hepatic glucose production, and insulin resistance via glucose transporter translocation.

Purpose of the Study:

  • To explore the complexities of glycemic regulation in critically ill patients.
  • To address discrepancies in findings regarding intensive insulin therapy's impact on survival.
  • To identify factors influencing optimal blood glucose (BG) control strategies.

Main Methods:

  • Review of pioneering studies and subsequent prospective randomized controlled trials on glycemic control.
  • Analysis of potential confounding factors: nutritional strategy, patient case-mix, optimal BG levels, hypoglycemia, and glucose variability.

Main Results:

  • A single study indicated improved survival with tight glycemic control via intensive insulin therapy.
  • Subsequent trials failed to consistently confirm these survival benefits.
  • Discrepancies are attributed to variations in nutritional support, patient populations, target BG, hypoglycemia management, and glucose variability.

Conclusions:

  • Further understanding of glycemic physiology and pathophysiology in acute illness is crucial.
  • Optimizing safe and effective glucose control requires refining BG targets and enhancing measurement techniques.
  • Future advancements may involve continuous monitoring, advanced insulin algorithms, and closed-loop systems.