Insulin: a wonder drug in the critically ill?
Stress hyperglycaemia is a common event in acute critical illness. There is increasing evidence that maintaining normoglycaemia and treatment with insulin (or with glucose-insulin-potassium [GIK]), even in non-diabetic persons, is helpful in limiting organ damage after myocardial infarction, stroke, traumatic brain injury and other conditions, even though the conditions may be accompanied by insulin resistance. A landmark study now suggests that maintaining normoglycaemia with intensive insulin treatment in a heterogeneous population of critically ill patients decreases morbidity and mortality. The potential mechanisms that underlie such a beneficial effect are discussed.
Johan Groeneveld
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Department of Intensive Care, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. johan.groeneveld@vumc.nl
Beishuizen
Albertus
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Visser
Frans C
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D000818:Animals; D003422:Critical Care; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007334:Insulin-Like Growth Factor I / Q000187:drug effects; D051381:Rats
D007004:Hypoglycemic Agents; D007328:Insulin; D007334:Insulin-Like Growth Factor I