title: Glycemic control in non-diabetic critically ill patients.
abstract: Hyperglycemia is a common and costly health care problem in hospitalized patients. In hospital hyperglycemia is defined as any glucose value >7.8 mmol/l (140 mg/dl). Hyperglycemia is present in 40% of critically ill patients and in up to 80% of patients after cardiac surgery, with ∼ 80% of ICU patients with hyperglycemia having no history of diabetes prior to admission. The risk of hospital complications relates to the severity of hyperglycemia, with a higher risk observed in patients without a history of diabetes compared to those with known diabetes. Improvement in glycemic control reduces hospital complications and mortality; however, the ideal glycemic target has not been determined. A target glucose level between 7.8 and 10.0 mmol/l (140 and 180 mg/dl) is recommended for the majority of ICU patients. This review aims to present updated recommendations for the inpatient management of hyperglycemia in critically ill patients with and without a history of diabetes.
authors.affiliation: Department of Medicine, Division of Endocrinology, Emory University School of Medicine, 49 Jesse Hill Jr Dr., Atlanta, GA 30303, USA. Farnoosh.farrokhi@emory.edu
authors.forename: Farnoosh
authors.initials: F
authors.lastname: Farrokhi
authors.forename: Dawn
authors.initials: D
authors.lastname: Smiley
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
mesh_terms: D003422:Critical Care / Q000639:trends; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000150:complications / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin