Patient-level glucose reporting: averages, episodes, or something in between?
The article by Van Herpe and colleagues in the previous issue of Critical Care describes the glycemic penalty index (GPI), which weights both hyperglycemic and hypoglycemic blood glucose measurements commensurate to their clinically significant difference from target. Although certain adverse consequences result from isolated severe hyperglycemic episodes, several specific outcomes depend upon overall hyperglycemia. In contrast, although mortality has been related epidemiologically to overall low blood glucose, specific negative outcomes may depend upon isolated episodes. Capturing both hypoglycemia and hyperglycemia in a single index will be shown to be useful if the GPI enables us to better define insulin strategies, outcomes, and targets.
Braithwaite
Susan S
SS
University of North Carolina - Chapel Hill, Highgate, Durham, NC 27713, USA. sbraithw@med.unc.edu
D000465:Algorithms; D001786:Blood Glucose / Q000187:drug effects*; D038321:Glycemic Index; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007362:Intensive Care Units; D024802:Nurse's Role
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin