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Best Pract Res Clin Endocrinol Metab. 2011 Oct;25(5):813-24. doi: 10.1016/j.beem.2011.05.004.

Glycemic control in non-diabetic critically ill patients.

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Department of Medicine, Division of Endocrinology, Emory University School of Medicine, 49 Jesse Hill Jr Dr., Atlanta, GA 30303, USA.


Hyperglycemia is a common and costly health care problem in hospitalized patients. In hospital hyperglycemia is defined as any glucose value >7.8 mmol/l (140 mg/dl). Hyperglycemia is present in 40% of critically ill patients and in up to 80% of patients after cardiac surgery, with ∼ 80% of ICU patients with hyperglycemia having no history of diabetes prior to admission. The risk of hospital complications relates to the severity of hyperglycemia, with a higher risk observed in patients without a history of diabetes compared to those with known diabetes. Improvement in glycemic control reduces hospital complications and mortality; however, the ideal glycemic target has not been determined. A target glucose level between 7.8 and 10.0 mmol/l (140 and 180 mg/dl) is recommended for the majority of ICU patients. This review aims to present updated recommendations for the inpatient management of hyperglycemia in critically ill patients with and without a history of diabetes.

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