Managing Blood Glucose Control in the ICU

Current evidence supports avoiding iatrogenic factors that aggravate hyperglycemia, such as early-PN and liberal corticosteroid use, and does not support TGC, except with accurate tools and protocols that prevent iatrogenic... read more

Accuracy of Continuous Glucose Monitoring Systems in ICU Patients

In this scoping review of CGM accuracy in the ICU, we found great diversity in accuracy reporting. Accuracy varied depending on CGM and comparator, and may be better for intravascular CGM and potentially lower during hypoglycemia. We... read more

Glucose Metabolism Disorders: Pre-hospital Oxygen Therapy and Saturation Variability in COVID-19 Patients

The COVID-19 pandemic has revealed that viruses can have multiple receptor properties, penetrating various tissues and causing mutations in various genes, thus promoting a range of metabolic disorders. The purpose of... read more

Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

In critically ill patients who were not receiving early parenteral nutrition, tight glucose control did not affect the length of time that ICU care was needed or mortality. Of 9,230 patients who underwent randomization,... read more

Polymorphism in Interferon Alpha/Beta Receptor Contributes to Glucocorticoid Response and Outcome of ARDS and COVID-19

Polymorphism in Interferon Alpha/Beta Receptor Contributes to Glucocorticoid Response and Outcome of ARDS and COVID-19

The distribution of this SNP within clinical study arms may explain the contradictory results of multiple ARDS studies and outcomes in COVID-19 concerning type I IFN signaling and glucocorticoids. We found a novel disease... read more

Saline vs. Balanced Crystalloid in Patients with Diabetic Ketoacidosis

Saline vs. Balanced Crystalloid in Patients with Diabetic Ketoacidosis

In patients with diabetic ketoacidosis (DKA), the use of saline may be associated with longer time to DKA resolution, higher post-resuscitation serum chloride levels, lower post-resuscitation serum bicarbonate levels, and... read more

The Importance of Accurate Glucose Monitoring in Critically Ill Patients

The Importance of Accurate Glucose Monitoring in Critically Ill Patients

Critically ill patients are not found just in intensive care units, but throughout the hospital: emergency departments, post-anaesthesia care units, operating rooms, and many other environments now care for the critically... read more

Impact of Tight Glucose Control on Circulating 3-hydroxybutyrate in Critically Ill Patients

Impact of Tight Glucose Control on Circulating 3-hydroxybutyrate in Critically Ill Patients

Tight versus liberal glucose control in the context of early parenteral nutrition did not affect 3-hydroxybutyrate concentrations in critically ill patients. Hence, the protective effects of tight glucose control in this... read more

Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS

Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS

Current literature addressing the pharmacological principles guiding glucocorticoid (GC) administration in ARDS is scant. This paucity of information may have led to the heterogeneity of treatment protocols and misinterpretation... read more

Perioperative Management of Glucose-lowering Drugs in Type 2 Diabetes Patients

Perioperative Management of Glucose-lowering Drugs in Type 2 Diabetes Patients

Patients with type 2 diabetes are commonly referred for elective or emergency surgery. In case of scheduled surgical procedures, previous guidelines recommended to withhold oral glucose-lowering drugs. Based on recent... read more

Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery

Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery

A FF strategy was not associated with changes to early enteral nutrition delivery. Inflammation, insulin resistance, and morbidity were similar, but FF may modify the relationship between inflammation and adverse event. Multicenter... read more

Relative Hypoglycemia in Diabetic Patients With Critical Illness

Relative Hypoglycemia in Diabetic Patients With Critical Illness

In ICU patients with diabetes, relative hypoglycemia is common, increases with higher hemoglobin A1C levels, and is a modifiable risk factor for both mortality and subsequent absolute hypoglycemia. These findings provide... read more

Relative Hyperglycemia Predicts In-Hospital Mortality in Critically Ill Patients

Relative Hyperglycemia Predicts In-Hospital Mortality in Critically Ill Patients

Unlike absolute hyperglycemia, relative hyperglycemia, as assessed by the stress hyperglycemia ratio, independently predicts in-hospital mortality in critically ill patients across the glycemic spectrum. Future studies should... read more

Glucose Variability as Measured by Inter-measurement Percentage Change is Predictive of In-patient Mortality in Aneurysmal Subarachnoid Hemorrhage

Glucose Variability as Measured by Inter-measurement Percentage Change is Predictive of In-patient Mortality in Aneurysmal Subarachnoid Hemorrhage

Reduced glucose variability is highly correlated with in-patient survival and long-term mortality in subarachnoid hemorrhage (aSAH) patients. This finding was observed in the non-diabetic and well-controlled diabetic patients,... read more

Lower Glucose Targets Show Improved Mortality in Cardiac Patients

Lower Glucose Targets Show Improved Mortality in Cardiac Patients

Tighter glucose control while minimizing the risk of severe hypoglycemia is associated with lower mortality among critically ill cardiac patents, new research suggests. Researchers reported in CHEST on the outcomes of... read more

POCUS Is Not a Magic Bullet

POCUS Is Not a Magic Bullet

A man in his 50s checked into our ED recently feeling weak, nauseated, and short of breath for two days. He had no significant medical history, and had previously been active and healthy. A fingerstick glucose at triage... read more

Incidence of Hypoglycemia in Following Insulin‐based Acute Treatment of Hyperkalemia

Incidence of Hypoglycemia in Following Insulin‐based Acute Treatment of Hyperkalemia

Iatrogenic hypoglycemia, as a result of treatment for hyperkalemia, is a common occurrence. Hyperkalemia occurs disproportionately in patients with acute kidney injury or end‐stage renal disease, and these patients are... read more