TY  - CHAP
M1  - Book, Section
TI  - Chapter 32. Glucose Management in Critical Care
A1  - Ciment, Ari J.
A1  - Romero, Joseph
A2  - Farcy, David A.
A2  - Chiu, William C.
A2  - Flaxman, Alex
A2  - Marshall, John P.
Y1  - 2012
N1  - 
T2  - Critical Care Emergency Medicine
AB  - The  American  Diabetes  Association  (ADA)  defines  inpatient  hyperglycemia  as  a  fasting  blood  glucose  (BG)  >126  mg/dL  or  a  random  BG  >200  mg/dL  that  reverts  to  normal  after  discharge.1  The  prevalence  of  hyperglycemia  in  the  acutely  ill  patient  in  the  intensive  care  unit  (ICU)  has  been  shown  to  be  as  high  as  83%.2  Hyperglycemia  in  critical  illness  may  occur  due  to  stress-related  surges  in  counterregulatory  hormones,  preexisting  diabetes,  impaired  glucose  tolerance,  and  insulin  resistance.  Whether  it  is  a  condition  necessitating  intervention  or  a  marker  of  disease  severity,  hyperglycemia  has  been  shown  to  be  an  independent  risk  factor  for  increased  mortality  in  the  ICU.3  Despite  this  association,  tight  glycemic  control  (TGC)  has  not  been  shown  to  consistently  improve  patient  outcomes  and  surprisingly  may,  in  some  subgroups,  cause  more  harm  than  good.  This  chapter  examines  the  historical  background,  essential  pathophysiology,  associations,  key  clinical  studies,  current  protocols,  and  recommendations  regarding  hyperglycemia  in  the  critically  ill.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/20
UR  - accessemergencymedicine.mhmedical.com/content.aspx?aid=55813893
ER  -