Glucose dysmetabolism and prognosis in critical illness

Chiara Lazzeri, Roberto Tarquini, Francesco Giunta, Gian Franco Gensini

Research output: Contribution to journalArticle

Abstract

Acute hyperglycemia frequently present in stress conditions, has long been generally accepted as normal, and not thought to be a cause for concern since a moderate hyperglycemia in critically ill adult patients has been thought to be beneficial during the "fight or flight" response to ensure a supply of glucose as a source of energy to organs that do not require insulin for glucose uptake (i.e., the brain and the immune system). However, an increasing body of evidence associates the upon-admission degree and duration of hyperglycemia during critical illness with an adverse outcome. Hyperglycemia should be regarded as a part of the systemic and complex metabolic derangements observed in critical illness in response to stress and inflammation, which can lead, independent of initial disease, to multiorgan dysfunction and death. A tight glycemic control should be constantly pursued and achieved by insulin infusion bearing in mind that the therapeutic target is fighting the systemic inflammatory response and not merely the glucose plasma levels.

Original languageEnglish
Pages (from-to)147-156
Number of pages10
JournalInternal and Emergency Medicine
Volume4
Issue number2
DOIs
Publication statusPublished - Apr 2009

Keywords

  • Critical illness
  • Hyperglycemia
  • Insulin resistance

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

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