TY - CHAP M1 - Book, Section TI - Glucose Management in Critical Care A1 - Ciment, Ari A1 - Romero, Joseph A1 - Saha, Debjit A2 - Farcy, David A. A2 - Chiu, William C. A2 - Marshall, John P. A2 - Osborn, Tiffany M. PY - 2016 T2 - Critical Care Emergency Medicine, 2e 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 cause more harm than good in some subgroups. This chapter examines the historical background, essential pathogenesis, associations, key clinical studies, current protocols, and recommendations regarding hyperglycemia in the critically ill. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1135702688 ER -