Glycemic control in critically ill patients

Stress hyperglycemia is commonly found in critically ill patients. Although the exact pathogenesis of the raised of blood sugar remains unclear, many clinicians believe that the combination of increased gluconeogenesis, glycogenolysis and insulin resistance may play a role. Also, an exact definition...

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Main Author: R Bhurayanontachai
Format: Article
Language:English
Published: Prince of Songkla University 2006-08-01
Series:Journal of Health Science and Medical Research (JHSMR)
Subjects:
Online Access:https://www.jhsmr.org/index.php/jhsmr/article/view/588
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author R Bhurayanontachai
author_facet R Bhurayanontachai
author_sort R Bhurayanontachai
collection DOAJ
description Stress hyperglycemia is commonly found in critically ill patients. Although the exact pathogenesis of the raised of blood sugar remains unclear, many clinicians believe that the combination of increased gluconeogenesis, glycogenolysis and insulin resistance may play a role. Also, an exact definition of stress hyperglycemia has not been established. However, stress hyperglycemia associated with the worst intensive care and hospital treatment outcomes has been reported in many clinical studies. Previously, many clinicians had commenced glycemic control when blood sugar rose above 200 mg/dl. This level of blood sugar had been accepted for commencing of glycemic control for years to avoid a medical complication that would otherwise occur, particularly in the postoperative period. Nevertheless, the method of glycemic control remained controversial. Recently, intensive glycemic control has resulted in better outcome in critical care settings, even though the level of glycemic control was not consistent between studies. All studies have applied the intensive insulin infusion protocol for continuously controlling blood glucose not only in postoperative patients but also in medically ill patients. This review will discuss the pathogenesis of stress hyperglycemia, the impact of hyperglycemia in critical care settings and methods of glycemic control based on current clinical studies.
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spelling doaj.art-074cb149871547f9b5864e611b22eaf42022-12-21T18:33:34ZengPrince of Songkla UniversityJournal of Health Science and Medical Research (JHSMR)2586-99812630-05592006-08-01244333345602Glycemic control in critically ill patientsR Bhurayanontachai0Critical Care Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,Stress hyperglycemia is commonly found in critically ill patients. Although the exact pathogenesis of the raised of blood sugar remains unclear, many clinicians believe that the combination of increased gluconeogenesis, glycogenolysis and insulin resistance may play a role. Also, an exact definition of stress hyperglycemia has not been established. However, stress hyperglycemia associated with the worst intensive care and hospital treatment outcomes has been reported in many clinical studies. Previously, many clinicians had commenced glycemic control when blood sugar rose above 200 mg/dl. This level of blood sugar had been accepted for commencing of glycemic control for years to avoid a medical complication that would otherwise occur, particularly in the postoperative period. Nevertheless, the method of glycemic control remained controversial. Recently, intensive glycemic control has resulted in better outcome in critical care settings, even though the level of glycemic control was not consistent between studies. All studies have applied the intensive insulin infusion protocol for continuously controlling blood glucose not only in postoperative patients but also in medically ill patients. This review will discuss the pathogenesis of stress hyperglycemia, the impact of hyperglycemia in critical care settings and methods of glycemic control based on current clinical studies.https://www.jhsmr.org/index.php/jhsmr/article/view/588stress hyperglycemiahyperglycemiaintensive insulin treatmentglycemic controlcritically ill
spellingShingle R Bhurayanontachai
Glycemic control in critically ill patients
Journal of Health Science and Medical Research (JHSMR)
stress hyperglycemia
hyperglycemia
intensive insulin treatment
glycemic control
critically ill
title Glycemic control in critically ill patients
title_full Glycemic control in critically ill patients
title_fullStr Glycemic control in critically ill patients
title_full_unstemmed Glycemic control in critically ill patients
title_short Glycemic control in critically ill patients
title_sort glycemic control in critically ill patients
topic stress hyperglycemia
hyperglycemia
intensive insulin treatment
glycemic control
critically ill
url https://www.jhsmr.org/index.php/jhsmr/article/view/588
work_keys_str_mv AT rbhurayanontachai glycemiccontrolincriticallyillpatients