Hyperglycemia should be Avoided in Critical Illness and the Postoperative Period

Kalpana Muthusamy, John M. Miles

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

Recent evidence from large clinical trials has cast into doubt the benefit of intensive insulin therapy to control hyperglycemia in the critically ill, and has in some instances shown harm from attempts to aggressively lower blood glucose. We argue that adverse results are linked to the occurrence of hypoglycemia, a problem made worse by excessively ambitious glucose targets in the context of an inappropriate definition of hypoglycemia (≤2.2 mmol/L) and methodology for point-of-care testing of blood glucose that lacks precision and accuracy. With an appropriate glucose target and careful avoidance of hypoglycemia, intensive therapy is safe and likely to benefit critically ill patients with hyperglycemia. We endorse the ADA/AACE current recommended glucose target range of 7.8-10.0 mmol/L

Original languageEnglish (US)
Title of host publicationClinical Dilemmas in Diabetes
PublisherWiley-Blackwell
Pages134-144
Number of pages11
ISBN (Print)9781405169288
DOIs
StatePublished - Mar 31 2011

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Keywords

  • Critical illness
  • Hypoglycemia
  • Intensive care
  • Intensive insulin therapy
  • Nutritional support

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Muthusamy, K., & Miles, J. M. (2011). Hyperglycemia should be Avoided in Critical Illness and the Postoperative Period. In Clinical Dilemmas in Diabetes (pp. 134-144). Wiley-Blackwell. https://doi.org/10.1002/9781444340280.ch15