Critical illness hyperglycemia: is failure of the beta-cell to meet extreme insulin demand indicative of dysfunction?
In the recent study by Preissig and Rigby in Critical Care, the authors argue that critical illness hyperglycemia in children with both respiratory failure and cardiovascular failure is due to a primary failure of the beta-cell. However, alternative explanations that the failure is secondary to an increase in insulin resistance leading to beta-cell exhaustion, or a negative impact of exogenous glucocorticoid therapy, may be equally likely.
Steil
Garry M
GM
Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
Agus
Michael S D
MS
D017209:Apoptosis; D016638:Critical Illness / Q000628:therapy; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000473:pathology
D007328:Insulin