How does blood glucose control with insulin save lives in intensive care?
Patients requiring prolonged intensive care are at high risk for multiple organ failure and death. Insulin resistance and hyperglycemia accompany critical illness, and the severity of this "diabetes of stress" reflects the risk of death. Recently it was shown that preventing hyperglycemia with insulin substantially improves outcome of critical illness. This article examines some potential mechanisms underlying prevention of glucose toxicity as well as the effects of insulin independent of glucose control. Unraveling the molecular mechanisms will provide new insights into the pathogenesis of multiple organ failure and open avenues for novel therapeutic strategies.
Van den Berghe
Greet
G
Department of Intensive Care Medicine, Catholic University of Leuven, Leuven, Belgium. greta.vandenberghe@med.kuleuven.ac.be
D001786:Blood Glucose / Q000378:metabolism*; D003422:Critical Care; D016638:Critical Illness; D005947:Glucose / Q000633:toxicity; D006801:Humans; D006943:Hyperglycemia / Q000473:pathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D008954:Models, Biological; D013997:Time Factors
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose