, Volume 40, Issue 7, pp 1049-1051
Date: 24 May 2014

Treatment thresholds for hyperglycemia in critically ill patients with and without diabetes

This is an excerpt from the content

Hyperglycemia is exceedingly common in critically ill patients. Although there is no accepted definition of acute hyperglycemia in the critical care setting, it is generally considered to be above 180–220 mg/dl (10.0–12.2 mmol/l). In the study by Plummer and colleagues reported in this issue of Intensive Care Medicine only 22.7 % of ICU patients were normoglycemic [1]. Glycemic control and the optimal blood glucose target are a subject of enormous controversy in critically ill patients. Retrospective and cohort studies in both ICU and hospitalized non-ICU patients have demonstrated a strong association between hyperglycemia and poor clinical outcomes [2]. It had therefore been assumed that “strict” glycemic control would improve patient outcomes. In 2001 van den Berghe et al. [3] reported that tight glycemic control (80–110 mg/dl, 4.4–6.1 mmol/l) improved the outcome of critically ill patients in a surgical intensive care unit. Subsequent studies, the most important being the NICE-SUGA