Diabetes and Hyperglycemia in the Critical Care Setting: Has the Evidence for Glycemic Control Vanished? (Or … Is Going Away?)
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Hyperglycemia is associated with increased mortality and other complications amongst hospitalized patients. However, the studies of tight glycemic control in a range of critical illness settings, including intensive care, acute myocardial infarction, and stroke, have produced inconsistent and divergent results. We examine some of the factors that may have contributed to the differing results, and their implications for targeting tight glucose control in critical illness. With these in mind, most clinical guidelines now recommend moderate glucose control with an upper glucose target of <10 mmol/L (180 mg/dL) in critical illness while avoiding hypoglycemia.
KeywordsHyperglycemia Diabetes Glucose Critical illness Hospital Intensive care Glycemic control Critical care setting
Compliance with Ethics Guidelines
Conflict of Interest
A.E. Wagstaff declares that she has no conflict of interest. N.W. Cheung declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article contains studies with human subjects performed by Dr. NW Cheung, who was a chief investigator in the HI-5 and QASC studies, both of which are human studies referred to in this paper. Both studies were approved by Ethics committees and informed consent was obtained from all participants in these studies.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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