Critical illness-induced dysglycaemia: diabetes and beyond.
Type 2 diabetes has reached epidemic proportions in many parts of the world. The disease is projected to continue to increase and double within the foreseeable future. Dysglycaemia develops in the form of hyperglycaemia, hypoglycaemia and marked glucose variability in critically ill adults whether they are known to have premorbid diabetes or not. Patients with such glucose dysregulation have increased morbidity and mortality. Whether this is secondary to cause and effect from dysglycaemia or is just related to critical illness remains under intense investigation. Identification of intensive care unit (ICU) patients with unrecognised diabetes remains a challenge. Further, there are few data regarding the development of type 2 diabetes in survivors after hospital discharge. This commentary introduces the concept of critical illness-induced dysglycaemia as an umbrella term that includes the spectrum of abnormal glucose homeostasis in the ICU. We outline the need for further studies in the area of glucose regulation and for follow-up of the natural history of abnormal glucose control during ICU admission and beyond.
Department of Anaesthesia, Critical Care and Pain, University of Warwick, Heart of England NHS Trust, Health Sciences Research Institute, Room A-102, Clinical Trial Unit, Warwick Medical School, Coventry, CV4 7AL, UK.
Fang Gao
FG
Smith
Ann M
AM
Sheehy
Jean-Louis
JL
Vincent
Douglas B
DB
Coursin
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism*; D016638:Critical Illness / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism* / Q000628:therapy*; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000378:metabolism / Q000628:therapy; D007362:Intensive Care Units / Q000639:trends
D001786:Blood Glucose