Update on glucose control during and after critical illness

Area of Science:

• Endocrinology
• Critical Care Medicine
• Metabolism

Background:

• Critical illness and disordered glucose metabolism share a complex, bidirectional relationship.
• Understanding this interplay is crucial for managing critically ill patients.

Purpose of the Study:

• To comprehensively review recent evidence on the relationship between critical illness and glucose metabolism.
• To examine this relationship across phases: before, during, and after intensive care unit (ICU) admission.

Main Methods:

• Review of recent scientific literature and clinical data.
• Focus on advancements in glucose monitoring, including near-continuous methods.
• Analysis of studies on glucose targets and management strategies.

Main Results:

• Preexisting glucose metabolism influences optimal blood glucose targets during critical illness.
• Near-continuous glucose monitoring shows promise for ICU glucose management.
• Stress hyperglycemia increases long-term diabetes risk, particularly in COVID-19 patients.

Conclusions:

• Personalized glucose targets are emerging as essential in critical care.
• Optimized glucose monitoring and post-ICU management are critical.
• Longitudinal follow-up is needed for patients experiencing stress hyperglycemia.