What are the current recommendations for glycemic control in critically ill patients?

What are the current recommendations for glycemic control in critically ill patients?

Current recommendation of glycemic control in ICU as per American Diabetic Association is to initiate insulin therapy for blood sugar at or above 180 mg/dl and to keep the glucose range between 140-180 mg/dl for majority of critically ill patient.

What is GC in ICU?

Hyperglycaemia is commonplace in the adult intensive care unit (ICU), associated with increased morbidity and mortality. Effective glycaemic control (GC) can reduce morbidity and mortality, but has proven difficult.

How do you maintain glycemic control?

Approaches for achieving glycemic control vary and include lifestyle modifications (ie, changes in diet and physical activity), oral medications, and/or an insulin regimen. Because diabetes is a progressive disease, intensification of management with oral medications and insulin is often required.

What is Glycaemic control?

Glycemic control is a medical term referring to the typical levels of blood sugar (glucose) in a person with diabetes mellitus.

How do you fix hyperglycemia in ICU?

Continuous intravenous insulin infusion is the most rational and physiologic method of management of hyperglycemia in ICU. Various studies have demonstrated that this method is safe, effective and flexible [2, 26, 27, 28]. It is imperative however to monitor blood glucose hourly and titrate the rate.

Why would a diabetic go to the ICU?

Admission of DM patients in intensive care units (ICU) can be due to various acute complications attributable to DM (diabetic ketoacidosis, hyperosmolar coma, and hypoglycemia), or some other underlying pathology and co-morbidity.

What does GC stand for in medicine?

List of medical abbreviations: G

What is a GC in medicine?

Gas chromatography (GC): A type of automated chromatography (a technique used to separate mixtures of substances) in which the mixture to be analyzed is vaporized and carried by an inert gas through a special column and thence to a detection device.

What is poor diabetic control?

In poorly controlled diabetes, a consistently high blood glucose concentration (hyperglycaemia) can damage all the major organs and organ systems, leading to characteristic complications of diabetes (McCance and Huether, 2014) (Table 1).

What is poor Glycaemic control?

Two main causes of poor glycaemic control has been describe in diabetic patients: lack of patient adherence to antidiabetic drugs and lack of treatment intensification by the physician.

How is glycemic control used in the ICU?

The GLUCONTROL trial examined the effect of IIT compared with conventional glucose control (target blood glucose concentration, 140-180 mg/dL [7.8-10.0 mmol]) on the mortality of patients admitted to 21 medical-surgical ICUs in Europe.

What should blood glucose be in ICU patients?

The first randomized controlled trial compared intensive insulin therapy (IIT) (target blood glucose concentration between 80 and 110 mg/dL [4.4-6.1 mmol/L]) with conventional insulin therapy (target blood glucose concentration of 180 to 200 mg/dL [10-11.1 mmol/L]) in surgical ICU patients. Intensive insulin therapy in the critically ill patients.

What is the role of insulin in glycemic control?

Insulin resistance and hyperglycemia in critical illness: role of insulin in glycemic control. The relationship between blood glucose level and QTc duration in the critically ill. A phase II randomised controlled trial of intensive insulin therapy in general intensive care patients.

What does Glu SD stand for in ICU?

Relationship between mortality and variability of blood glucose control in critically ill patients. The Glu SD during ICU stay was used as a marker of variability of blood glucose control. Glu SD = SD of blood glucose concentration.