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Related Concept Videos

Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

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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...
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Glucose Transporters01:27

Glucose Transporters

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Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
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Glucose Absorption Into the Small Intestine01:26

Glucose Absorption Into the Small Intestine

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Complex carbohydrates consumed cannot be absorbed into the small intestine in their original form. First, they must be hydrolyzed to a monosaccharide form such as glucose or galactose. These monosaccharides are then transported across the intestinal membrane and into the blood via transcellular transport. The intestinal epithelial cells allow the movement of these monosaccharides with a defined 'entry' through membrane transporter proteins present on their apical membrane and...
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Hormones Regulating Blood Glucose01:16

Hormones Regulating Blood Glucose

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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...
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Control System Problem01:21

Control System Problem

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In an open-loop system, such as a basic thermostat, the poles of the transfer function influence the system's response but do not determine its stability. However, when feedback is introduced to form a closed-loop system, such as an advanced thermostat that adjusts heating based on room temperature, stability is governed by the new poles of the closed-loop transfer function.
When forming a closed-loop system, issues can arise if the poles cross into the unstable region, leading to potential...
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are...
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Updated: Jan 28, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

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Glucose control in the ICU.

Jan Gunst1, Astrid De Bruyn, Greet Van den Berghe

  • 1Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.

Current Opinion in Anaesthesiology
|March 1, 2019
PubMed
Summary
This summary is machine-generated.

Tight glucose control in intensive care units (ICUs) shows mixed results. While beneficial in specific contexts like early parenteral nutrition, the ideal blood glucose target for critically ill patients remains uncertain.

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A Simple Flow Cytometric Method to Measure Glucose Uptake and Glucose Transporter Expression for Monocyte Subpopulations in Whole Blood
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Area of Science:

  • Critical care medicine
  • Endocrinology
  • Metabolic disorders

Background:

  • Hyperglycemia is common in critically ill patients and linked to poor outcomes.
  • The causal relationship between hyperglycemia and adverse outcomes is debated.
  • Current evidence on glucose control in the ICU is complex and evolving.

Purpose of the Study:

  • To review recent evidence on glucose control strategies in the ICU.
  • To explore the benefits and risks of tight glucose control in critical care.
  • To identify factors influencing the effectiveness of glucose management.

Main Methods:

  • Review of recent randomized controlled trials and multicenter studies.
  • Analysis of methodological differences in glucose control trials.
  • Evaluation of strategies to enhance tight glucose control efficacy and safety.

Main Results:

  • Pioneer trials suggested benefits of tight glucose control, but later studies yielded conflicting results.
  • Potential harm was observed in one trial, possibly due to methodological variations.
  • Computerized treatment algorithms are being developed to improve glucose control safety and efficacy.

Conclusions:

  • The optimal blood glucose target in the ICU is context-dependent and not definitively established.
  • Tight glucose control is well-tolerated and effective with early parenteral nutrition and strict protocols.
  • Patients with poorly controlled diabetes may require less aggressive glucose management; benefits without early parenteral nutrition are unclear.