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Glucose Variability in Critically Ill Patients

  • Conference paper
Intensive Care Medicine

Abstract

The presence of stress-induced hyperglycemia in critically ill patients, especially in those without evidence of antecedent diabetes, is a well established marker of poor outcomes [1–4]. Two large single center studies comparing the standard strategy of permissive hyperglycemia to use of intravenous insulin to achieve a blood glucose between 80 and 110 mg/dl (intensive insulin therapy) demonstrated overall clinical benefit with the intensive insulin therapy [5, 6]. However, more recent studies of insulin therapy in critically ill patients have yielded conflicting results [7]. In addition, a growing awareness of the potential risks of hypoglycemia, which can occur more frequently when using intravenous insulin therapy, has raised concerns over the best way to control glucose. Despite this, reverting back to allowing hyperglycemia to continue unchecked is unlikely to be the correct approach either.

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Author information

Authors and Affiliations

  1. Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, 201G DHLRI, Columbus, OH, 43210, USA

    N. A. Ali

  2. Department of Critical Care Stamford Hospital, Columbia University College of Physicians and Surgeons, 190 W Broad St., Stamford, CT, 06902, USA

    J. S. Krinsley

  3. Department of Intensive Care, Centre Hospitalier Universitaire de Liège, Domaine Universitaire Sart Tilman B35, 4000, Liège 1, Belgium

    J.-C. Preiser

Authors
  1. N. A. Ali
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  2. J. S. Krinsley
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  3. J.-C. Preiser
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Editor information

Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Universitée libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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© 2009 Springer-Verlag Berlin Heidelberg

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Ali, N.A., Krinsley, J.S., Preiser, JC. (2009). Glucose Variability in Critically Ill Patients. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92278-2_67

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  • DOI: https://doi.org/10.1007/978-0-387-92278-2_67

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-92277-5

  • Online ISBN: 978-0-387-92278-2

  • eBook Packages: MedicineMedicine (R0)

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