Propofol-Induced Hyperglycemia in the Critically Ill: An Unfamiliar Side Effect of a Common Anesthetic

Hyperglycemia is associated with increased in-hospital morbidity and mortality, especially in critically ill intensive care unit (ICU) patients. Propofol, a common anesthetic used in the ICU, may cause hyperglycemia by inducing insulin resistance, reducing insulin-stimulated glucose uptake in muscles, and attenuating insulin-mediated suppression of hepatic glucose. We present the case of a 58-year-old female who was admitted for sepsis secondary to cellulitis but required intubation for respiratory failure. She was provided propofol for sedation and went on to develop propofol-induced hyperglycemia. This is one of the few documented human cases demonstrating the association between propofol and hyperglycemia. There are animal-based studies that demonstrate this effect as well. This case report highlights the fact that propofol-induced hyperglycemia should be a consideration when deciding sedation strategies in critically ill patients.