Glucose Management Technologies for the Critically Ill. J Diabetes Sci Technol 2019 Jul;13(4):682-690
Date
01/15/2019Pubmed ID
30638048Pubmed Central ID
PMC6610597DOI
10.1177/1932296818822838Scopus ID
2-s2.0-85060757109 (requires institutional sign-in at Scopus site) 22 CitationsAbstract
Hyperglycemia is common in the intensive care unit (ICU) both in patients with and without a previous diagnosis of diabetes. The optimal glucose range in the ICU population is still a matter of debate. Given the risk of hypoglycemia associated with intensive insulin therapy, current recommendations include treating hyperglycemia after two consecutive glucose >180 mg/dL with target levels of 140-180 mg/dL for most patients. The optimal method of sampling glucose and delivery of insulin in critically ill patients remains elusive. While point of care glucose meters are not consistently accurate and have to be used with caution, continuous glucose monitoring (CGM) is not standard of care, nor is it generally recommended for inpatient use. Intravenous insulin therapy using paper or electronic protocols remains the preferred approach for critically ill patients. The advent of new technologies, such as electronic glucose management, CGM, and closed-loop systems, promises to improve inpatient glycemic control in the critically ill with lower rates of hypoglycemia.
Author List
Salinas PD, Mendez CEAuthor
Carlos Eduardo Mendez Castrillo MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Blood GlucoseBlood Glucose Self-Monitoring
Critical Illness
Humans
Hyperglycemia
Hypoglycemia
Hypoglycemic Agents
Insulin
