 | fluid and electrolyte loss |
| WBC dysfunction - delayed phagocytosis |
| gastroparesis |
Summary for Goal Section
Overall glucose goals for general hospital diabetes patients: 80-180 mg/dl
| While lower levels for diabetic patients have been written about, there is no current evidence to back this up. | ||||||
| When glucoses are higher than this the following problems may occur:
|
Glucose goal for post surgical ICU patients (not diabetes specific): 80-120 mg/dl
| This is based on single New England Journal Paper with improved outcomes. |
| Additional single site study on medical ICU patients showed similar improvement only for patients who were in the ICU for >3 days. |
| New studies on IV insulin in MI patients have not shown benefit |
| New large scale studies on GIK (glucose-insulin-potassium) in cardiac patients have not shown benefit |
| There are now 3 large international multicenter studies to determine the true benefit of this ICU glucose control |
Problems with High Glucoses:
| Studies have shown that high glucoses in hospitalized
diabetes patients are associated with:
|
Benefit of improving glucose level in the hospitalized Diabetic patient (prospective studies):
| Studies have shown that combinations intravenous insulin
and other aggressive use of insulin in hospitalized diabetes patients to
manage glucose levels are associated with:
|