Tag: hypoglycemia
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
Addressing Hospital-Acquired Hypoglycemia
Findings suggest that ensuring a consistent 30-minute window between POC BG measurement and meal delivery enabled nursing staff to perform timely POC BG measurements and administer a more optimal mealtime insulin dose. Increasing... read more
Use of a Machine Learning Model to Predict Iatrogenic Hypoglycemia
These findings suggest that iatrogenic hypoglycemia can be predicted in a short-term prediction horizon after each BG measurement during hospitalization. Further studies are needed to translate this model into a real-time... read more
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
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
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
Interventions for Preventing Critical Illness Polyneuropathy and Critical Illness Myopathy
There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the... read more
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
Hypertriglyceridemic pancreatitis: Can we defuse the bomb?
Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more
Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis
Patients with sepsis and a pre-existing diagnosis of insulin-treated diabetes (ITD) may show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 hours than... read more
Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes
Ludwig Lin, MD, speaks with Palash Kar, MBBS, about the article, "Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes: An Exploratory Study," published in Critical Care Medicine. In this article, Dr.... read more
Glycaemic Control Targets After TBI
This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more
A comparison of two insulin infusion protocols in the ICU by continuous glucose monitoring
The Yale protocol provided better average glycemia, more time spent in normoglycemia, less time in hypoglycemia, and less glycemic variability than the Leuven protocol, but was not independently associated with strict glycemic... read more
Glycemic control, mortality, and hypoglycemia in critically ill patients
Network meta-analysis showed no mortality benefit of tight glycemic control in critically ill patients, but fivefold more hypoglycemia versus mild or very mild control. Thirty-six randomized trials (17,996 patients) were... read more
Care that Matters: Quality Measurement and Health Care
Barry Saver and colleagues caution against the use of process and performance metrics as health care quality measures in the United States. There is limited evidence that many "quality" measures - including those... read more
Low Blood Glucose Levels In Hospitalized Patients Linked To Increased Mortality Risk
Mortality risk was higher in insulin-treated patients with moderate hypoglycemia (40-70 mg/dL), compared to patients without insulin treatment with similar glucose values.... read more
Glycemic control, mortality, and hypoglycemia in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials
Network meta-analysis showed no mortality benefit of tight glycemic control in critically ill patients, but fivefold more hypoglycemia versus mild or very mild control.... read more
