RT Book, Section 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. SR Print(0) ID 1135702688 T1 Glucose Management in Critical Care T2 Critical Care Emergency Medicine, 2e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071838764 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1135702688 RD 2024/10/16 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.