Glycemic Control in Critically Ill Surgical Patients

  • Brian C. Beldowicz
  • Jeremiah J. Duby
  • Danielle Pigneri
  • Christine S. Cocanour
Chapter

Abstract

Alterations in glucose production, distribution, and utilization are frequently observed in critical illness. Whether these alterations are a cause or consequence of illness, beneficial or detrimental to recovery, remains to be fully understood. It will be the focus of this chapter to provide an evidence-based, formulaic approach to insulin therapy that proactively incorporates each patient’s baseline state of health as well the expected evolution of their acute disease process and therapeutic needs. The chapter will provide methods for the reactive, fine-tuning of blood glucose management that utilizes information derived from the early stages of glucose control while transitioning to more reliable, less labor-intensive insulin regimens. Lastly, it will provide a method for dealing with the complications of glycemic control that result in dangerous levels of hyper- and hypoglycemia.

Keywords

Glycemic control Acute dysglycemia Hyperglycemia Hypoglycemia Glycemic variability Insulin therapy Insulin sensitivity 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Brian C. Beldowicz
    • 1
  • Jeremiah J. Duby
    • 2
    • 3
    • 4
  • Danielle Pigneri
    • 1
  • Christine S. Cocanour
    • 1
  1. 1.Department of Surgery, Division of TraumaUC Davis Health, Acute Care Surgery and Surgical Critical CareSacramentoUSA
  2. 2.Department of Pharmacy ServicesUC Davis HealthSacramentoUSA
  3. 3.Touro University, College of PharmacyVallejoUSA
  4. 4.UCSF School of PharmacySan FranciscoUSA

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