Glycemic control and nutrition in the intensive care unit.
OBJECTIVE
Hospital clinicians frequently encounter hyperglycemia due to diabetes or the stress of critical illness in patients who are receiving nutrition support.


RESULTS
A growing body of evidence suggests that hyperglycemia in the hospital is associated with adverse outcomes (e.g. disability after acute cardiovascular events, infection and death) and that improvement in outcomes can be achieved with improved glycemic control or insulin. Therefore, familiarity with the implications of hyperglycemia and with its treatment are essential for clinicians practicing in hospital settings.


CONCLUSIONS
Questions persist regarding the optimal glucose goal range in differing patient groups. In addition, while the technology to deliver glycemic control in intensive care unit settings is widely available, data are limited about effective and safe insulin infusions. Research should focus on the risks and benefits of providing nutrition support in this group of patients, optimal glucose goal ranges, and on methods of achieving desired glucose goal ranges.
Division of Endocrinology, Diabetes, Metabolism, Nutrition and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. mcmahon.molly@mayo.edu
M Molly
MM
McMahon
John M
JM
Miles
D001786:Blood Glucose / Q000378:metabolism*; D003422:Critical Care / Q000379:methods / Q000592:standards; D016638:Critical Illness / Q000628:therapy*; D004734:Energy Metabolism / Q000502:physiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D009751:Nutritional Requirements; D018529:Nutritional Support
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin