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Related Concept Videos

Hyperglycemia01:29

Hyperglycemia

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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...
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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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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...
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Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

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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...
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Overview of Carbohydrate Metabolism01:19

Overview of Carbohydrate Metabolism

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Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
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Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

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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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SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

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SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
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Related Experiment Video

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Improving IV Insulin Administration in a Community Hospital
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Glycemic variability and outcome in critically ill.

Subhash Todi1, Mahuya Bhattacharya1

  • 1Department of Critical Care Medicine, AMRI Hospitals, Kolkata, West Bengal, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|June 11, 2014
PubMed
Summary

High glucose variability (GV) is linked to increased intensive care unit (ICU) mortality. This association is significant even for patients with blood glucose levels in the normal range, highlighting GV as a critical prognostic indicator.

Keywords:
Critically illglycemic lability indexglycemic variabilityhypoglycemiaintensive care unit mortality

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Clinical Pathology

Background:

  • Glycemic control encompasses acute hyperglycemia, hypoglycemia, and glycemic variability (GV), all impacting patient outcomes.
  • Glycemic variability may confound results in tight glycemic control trials.

Purpose of the Study:

  • To investigate the relationship between glycemic variability and intensive care unit (ICU) mortality within the Indian population.
  • To assess GV as a prognostic marker in critically ill patients.

Main Methods:

  • Retrospective analysis of a prospectively collected database.
  • Inclusion of adult patients from Medical, Surgical, Trauma, and Neuro ICUs at a tertiary care hospital.
  • Analysis of patients with at least four blood glucose measurements during their ICU stay.

Main Results:

  • A cohort of 2208 patients with 11,335 blood glucose values was analyzed.
  • Both standard deviation (SD) and glycemic lability index (GLI) of blood glucose were significantly associated with increased ICU mortality (P < 0.001).
  • Elevated GV correlated with higher mortality, particularly in patients with blood glucose levels within the euglycemic range.

Conclusions:

  • Increased glycemic variability is a significant predictor of higher ICU mortality in a diverse group of critically ill patients.
  • The prognostic impact of GV is pronounced even when blood glucose levels are within the euglycemic range.