Journal
AACN ADVANCED CRITICAL CARE
Volume 17, Issue 1, Pages 50-55Publisher
AMER ASSOC CRITICAL CARE NURSES
DOI: 10.1097/00044067-200601000-00007
Keywords
critical illness; hyperglycemia; insulin resistance; intensive insulin therapy
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Hyperglycemia and insulin resistance are common among critically ill patients and occur in patients with or without a history of diabetes mellitus. All patients undergoing critical illness are at risk for stress-induced hyperglycemia. Some patients may be at greater risk for hyperglycemia than others when considering underlying disease states and iatrogenic factors. Many recent studies demonstrate that tight glucose control can decrease morbidity and mortality associated with critical illness. This article reviews the pathophysiology behind stress-induced hyperglycemia, the evidence to support tight glycemic control, and the importance of an intensive insulin therapy protocol to standardize treatment among critical care patients.
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