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Carbohydrate Provision in the Era of Tight Glucose Control

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Abstract

Glycemic control in the critically ill patient has remained a controversial issue over the last decade. Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbidity. Nutritional support has evolved into an additional area of critical care where appropriate practices have been associated with improved patient outcomes. Carbohydrate provision can impact blood-glucose levels, and the relationship between nutrition and glucose levels has become more complex in the era of improved glycemic control. This review discusses the controversy surrounding intensive-insulin therapy in the intensive care unit and explores the relationship with nutritional support, both in the enteral and parenteral form. Achieving realistic goals in both carbohydrate provision and glycemic control may improve patient outcome, and are not mutually exclusive practices.

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Authors and Affiliations

  1. Department of Surgery, University of Louisville, ACB 2nd Floor, 550 South Jackson Street, Louisville, KY, 40202, USA

    Keith R. Miller

  2. Department of Surgery, Division of Trauma/Critical Care, University of Tennessee, Medical Center, Knoxville, 1924 Alcoa Highway, Box U-11, Knoxville, TN, 37920, USA

    Christy M. Lawson

  3. Department of Surgery, Division of Trauma/Critical Care, Stanford University, 300 Pasteur Drive, Room H3591, Stanford, CA, 94305–5641, USA

    Vance L. Smith

  4. Department of Surgery, University of Louisville, 550 S Jackson St., Louisville, KY, 40292, USA

    Brian G. Harbrecht

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  1. Keith R. Miller
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Correspondence to Keith R. Miller.

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Miller, K.R., Lawson, C.M., Smith, V.L. et al. Carbohydrate Provision in the Era of Tight Glucose Control. Curr Gastroenterol Rep 13, 388–394 (2011). https://doi.org/10.1007/s11894-011-0204-x

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