Hyperglycemia in sepsis

Sepsis is a life-threatening condition characterized by acute organ dysfunction resulting from the host's maladaptive response to infectious agents. Hyperglycemia is a common complication in sepsis patients, driven by multiple pathological mechanisms. The four main mechanisms are abnormal glucose metabolism caused by increased secretion of counterregulatory hormones, insulin resistance triggered by the release of pro-inflammatory mediators, enhanced warburg effect and excessive degradation of dipeptidyl peptidase IV. Abnormal blood glucose levels have been recognized as an independent risk factor for poor prognosis in sepsis, significantly increasing the risk of death. While optimal glycemic management is critical, requirements vary across patient populations, necessitating individualized strategies. This article reviews the mechanism of hyperglycemia caused by sepsis, blood glucose management, and hypoglycemic drugs that can improve sepsis-related indicators, aiming to provide guidance for the clinical diagnosis and treatment of sepsis complicated with stress-induced hyperglycemia.