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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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Related Experiment Video

Updated: Feb 17, 2026

Improving IV Insulin Administration in a Community Hospital
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Glycemic control in acute illness.

Moritoki Egi1, Nana Furushima1, Shohei Makino1

  • 1Department of Anesthesiology, Kobe University Hospital, Kobe, Japan.

Korean Journal of Anesthesiology
|December 12, 2017
PubMed
Summary
This summary is machine-generated.

Critically ill patients often have hyperglycemia. Optimal blood glucose control targets may differ for those with and without pre-existing diabetes, requiring further research.

Keywords:
Acute illnessDiabetes mellitusGlucoseGlucose measurementHyperglycemiaInsulin

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Area of Science:

  • Critical care medicine
  • Endocrinology
  • Clinical chemistry

Background:

  • Hyperglycemia affects over 97% of critically ill patients.
  • Extensive research, including meta-analyses, has explored optimal acute glycemic control targets.
  • Hypoglycemia's adverse outcomes are observed, but causality remains unconfirmed.

Purpose of the Study:

  • To review current evidence on acute glycemic control in critical illness.
  • To discuss the complexities of managing hyperglycemia in patients with premorbid diabetes.
  • To highlight the need for further research into optimal glucose targets for specific patient populations.

Main Methods:

  • Review of randomized controlled trials (RCTs), meta-analyses, and network meta-analyses.
  • Analysis of studies investigating glycemic control targets in critically ill patients.
  • Examination of literature on acute glycemic control in patients with premorbid hyperglycemia.

Main Results:

  • Recommended serum glucose levels for critically ill patients are generally between 144-180 mg/dl.
  • Hypoglycemia is associated with worse outcomes, prompting recommendations for avoidance.
  • Optimal glycemic targets may need to be higher for critically ill patients with premorbid hyperglycemia.

Conclusions:

  • Acute glycemic control in critical illness requires careful consideration of individual patient factors.
  • Patients with premorbid hyperglycemia may benefit from higher glucose targets.
  • Further research is essential to establish precise glycemic control strategies for diverse critically ill populations.