Hyperglycemia in the Critically Ill: Consequences and Treatment

ABSTRACT

Laura E. Ridge

Hyperglycemia has long been recognized as a common occurrence in the critically ill, even without a history of diabetes. During times of stress or injury, nonnal glucose metabolism is altered because of changes in endocrine secretions and peripheral insulin resistance, resulting in stress hyperglycemia. Although hyperglycemia is a nonnal part of the stress response, it has recently been recognized to be associated with increased mortality and morbidity. Furthennore, insulin therapy has been shown to decrease mortality and improve other patient outcomes. However, many questions remain unanswered concerning the efficacy of insulin therapy. It is still unclear how tight glucose control should be and which patient types benefit from the treatment. More research is needed before insulin therapy can be widely used.