Stress Hyperglycemia and Glycemic Control

  • Paul Ellis Marik


Stress hyperglycemia is common in critically ill and injured patients and is a component of the “fight-and-flight” response. Until recently, stress hyperglycemia was considered a beneficial adaptive response, with the raised blood glucose providing a ready source of fuel for the brain, skeletal muscle, heart, and other vital organs at a time of increased metabolic demand. However, retrospective studies in patients undergoing cardiac surgery suggested that perioperative hyperglycemia was associated with an increased risk of postoperative infections and increased mortality.1–3 Furthermore, these studies suggested that control of blood glucose reduced these complications. Following the first Leuven Intensive Insulin Therapy Trial in 2001, “tight glucose control” became regarded as the standard of care in all ICU patients around the world.4


Blood Glucose Insulin Infusion Intensive Insulin Therapy Tight Glycemic Control Tight Glucose Control 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care MedicineEastern Virginia Medical SchoolNorfolkUSA

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