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Related Concept Videos

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...
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...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
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...
Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
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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Hyperglycemia in critical illness.

Kyle A Weant1, Abby M Bailey, Stephanie N Baker

  • 1North Carolina Public Health Preparedness and Response, North Carolina Department of Health and Human Services, Raleigh, NC 27699, USA. kaw9600@alumni.unc.edu

Advanced Emergency Nursing Journal
|August 1, 2013
PubMed
Summary
This summary is machine-generated.

Acute injury and critical illness can cause hyperglycemia, or high blood sugar. Recent research highlights both the risks of this condition and the dangers of overly strict glucose control, creating a clinical challenge.

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Area of Science:

  • Critical care medicine
  • Endocrinology
  • Emergency medicine

Background:

  • Hyperglycemia is a known complication of acute injury and critical illness.
  • Recent research has focused on the adverse effects of hyperglycemia and the benefits of glucose control in critically ill patients.
  • Emerging evidence suggests potential harm from overly strict glucose control.

Purpose of the Study:

  • To review the evolution of research on critical illness hyperglycemia.
  • To analyze various published guidelines for glucose management in critically ill patients.
  • To discuss the clinical implications for managing hyperglycemia, particularly in emergency departments.

Main Methods:

  • Literature review of studies on critical illness hyperglycemia.
  • Analysis of prominent clinical practice guidelines.
  • Synthesis of research findings and guideline recommendations.

Main Results:

  • A shift in understanding from solely focusing on hyperglycemia to recognizing risks of tight glucose control.
  • Development of multiple, sometimes conflicting, clinical guidelines.
  • Identification of a complex clinical dilemma for healthcare providers.

Conclusions:

  • Managing hyperglycemia in critical illness requires a nuanced approach, balancing risks and benefits.
  • Current guidelines offer some direction but highlight ongoing challenges.
  • Further research and refined protocols are needed for optimal patient outcomes.