Blood sugar control in the intensive care unit: time to relook

Rapsang, Amy G.; Shyam, Devajit C.
August 2014
Southern African Journal of Anaesthesia & Analgesia;2014, Vol. 20 Issue 4, p185
Academic Journal
The choice of blood sugar control technique in the intensive care unit (ICU) has long been debated. Intensive insulin therapy to achieve normoglycaemia has been shown to reduce mortality, morbidity and the length of ICU stay, but at the same time, frequent glucose monitoring is required, as well as an adjustment to the insulin dose. There is also an increase in the medical personnel workload. However, despite its clinical benefits, intensive blood sugar control is not favoured by the intensivist because of the risk of hypoglycaemia. This article provides the reader with an interesting thought. Can intensive blood sugar control be implemented in the ICU, while avoiding hypoglycaemia, and without an increase in hospital costs, and thus change existing blood sugar control protocols in the ICU? Is this possible with the use of continuous glucose monitoring devices which have recently emerged as a tool to be used to maintain proper glucose levels? If further developed, continuous glucose monitoring technology could ultimately prove to be clinically useful in the ICU. However, further research is warranted to confirm its benefits in connection with the implementation of tight glucose control policies in the ICU.


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