Tags

Type your tag names separated by a space and hit enter

Current controversies around tight glucose control in critically ill patients.
Curr Opin Clin Nutr Metab Care. 2007 Mar; 10(2):206-9.CO

Abstract

PURPOSE OF REVIEW

This review updates our knowledge on the benefits and risks of tight glucose control by intensive insulin therapy in critically ill patients, as well as discussing unanswered questions related to the subject.

RECENT FINDINGS

At the cellular level, the toxic effects of elevated and highly variable glucose concentration are related to an increase in oxidative stress and to several toxic intracellular derivates generated as by-products of the glycolytic pathway. Clinically, several recent studies have suggested that the optimal target for blood glucose may be higher than the 'normal' values of 4.4-6.1 mmol/l for various categories of patients. Also, the variability in glucose level appears to be an important determinant of glucose toxicity. Conflicting data on the hazards of hypoglycaemia are emerging.

SUMMARY

Practical recommendations for the implementation of tight glucose control using intensive insulin therapy cannot be disseminated until questions relating to optimal blood glucose level and the corresponding categories of patients have been resolved. The issues of glucose variability and the most efficient method of preventing hypoglycaemia will probably represent important parameters for comparing the safety and quality of protocols used for tight glucose control.

Authors+Show Affiliations

Department of Intensive Care, Centre Hospitalier, Universitaire du Sart Tilman, Liège, Belgium.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17285011

Citation

Devos, Philippe, and Jean-Charles Preiser. "Current Controversies Around Tight Glucose Control in Critically Ill Patients." Current Opinion in Clinical Nutrition and Metabolic Care, vol. 10, no. 2, 2007, pp. 206-9.
Devos P, Preiser JC. Current controversies around tight glucose control in critically ill patients. Curr Opin Clin Nutr Metab Care. 2007;10(2):206-9.
Devos, P., & Preiser, J. C. (2007). Current controversies around tight glucose control in critically ill patients. Current Opinion in Clinical Nutrition and Metabolic Care, 10(2), 206-9.
Devos P, Preiser JC. Current Controversies Around Tight Glucose Control in Critically Ill Patients. Curr Opin Clin Nutr Metab Care. 2007;10(2):206-9. PubMed PMID: 17285011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current controversies around tight glucose control in critically ill patients. AU - Devos,Philippe, AU - Preiser,Jean-Charles, PY - 2007/2/8/pubmed PY - 2007/5/1/medline PY - 2007/2/8/entrez SP - 206 EP - 9 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 10 IS - 2 N2 - PURPOSE OF REVIEW: This review updates our knowledge on the benefits and risks of tight glucose control by intensive insulin therapy in critically ill patients, as well as discussing unanswered questions related to the subject. RECENT FINDINGS: At the cellular level, the toxic effects of elevated and highly variable glucose concentration are related to an increase in oxidative stress and to several toxic intracellular derivates generated as by-products of the glycolytic pathway. Clinically, several recent studies have suggested that the optimal target for blood glucose may be higher than the 'normal' values of 4.4-6.1 mmol/l for various categories of patients. Also, the variability in glucose level appears to be an important determinant of glucose toxicity. Conflicting data on the hazards of hypoglycaemia are emerging. SUMMARY: Practical recommendations for the implementation of tight glucose control using intensive insulin therapy cannot be disseminated until questions relating to optimal blood glucose level and the corresponding categories of patients have been resolved. The issues of glucose variability and the most efficient method of preventing hypoglycaemia will probably represent important parameters for comparing the safety and quality of protocols used for tight glucose control. SN - 1363-1950 UR - https://www.unboundmedicine.com/medline/citation/17285011/Current_controversies_around_tight_glucose_control_in_critically_ill_patients_ L2 - https://doi.org/10.1097/MCO.0b013e3280147d2d DB - PRIME DP - Unbound Medicine ER -