Glycemic Control in Non Diabetic Critically Ill Patients

INTRODUCTION

Farnoosh Farrokhi, MD, Fellow of Endocrinology, Dawn Smiley, MD, Assistant Professor of Medicine, Guillermo E. Umpierrez, MD, Professor of Medicine

Hyperglycemia is a common and costly health care problem in hospitalized patients. In hospital hyperglycemia is defined as any glucose value >7.8 mmol/l (140 mg/dl). Hyperglycemia is present in 40% of critically ill patients and in up to 80% of patients after cardiac surgery, with w 80% of ICU patients with hyperglycemia having no history of diabetes prior to admission. The risk of  hospital complications relates to the severity of hyperglycemia, with a higher risk observed in patients without a history of diabetes compared to those with known diabetes. Improvement in

glycemic control reduces hospital complications and mortality; however, the ideal glycemic target has not been determined. A target glucose level between 7.8 and 10.0 mmol/l (140 and 180 mg/dl) is recommended for the majority of ICU patients. This

review aims to present updated recommendations for the inpatient management of hyperglycemia in critically ill patients with and without a history of diabetes. 

Best Practice & Research Clinical Endocrinology & Metabolism 25 (2011) 813–824.

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