Glycemic control

Shaun E. Gruenbaum; Raphael A.O. Bertasi; Tais G.O. Bertasi; Benjamin F. Gruenbaum; Federico Bilotta

doi:10.1016/B978-0-12-821776-4.00028-7

Glycemic control

Shaun E. Gruenbaum, Raphael A.O. Bertasi, Tais G.O. Bertasi, Benjamin F. Gruenbaum, Federico Bilotta

Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review

1 Scopus citations

Abstract

Disruptions in blood glucose homeostasis are commonly observed in neuro-critically ill patients and are strongly associated with an increased risk of morbidity and mortality. Despite this association, there is currently a lack of consensus regarding the optimal target blood glucose concentration for these patients and how to best achieve this target. In this chapter, we discuss the pathophysiology of stress-induced hyperglycemia and review the evidence-based recommendations for glycemic control in neuro-critically ill patients. In recent years, aggressive insulin therapy regimens have failed to confer clear outcomes benefits over a more conventional insulin therapy approach and are associated with an increased risk of hypoglycemia. For these reasons, the current evidence supports the maintenance of blood glucose concentrations < 180mg/dL with a target blood glucose concentration between 140 and 180mg/dL.

Original language	English
Title of host publication	Essentials of Evidence-Based Practice of Neuroanesthesia and Neurocritical Care
Publisher	Elsevier
Pages	389-394
Number of pages	6
ISBN (Electronic)	9780128217764
ISBN (Print)	9780128218280
DOIs	https://doi.org/10.1016/B978-0-12-821776-4.00028-7
State	Published - 1 Jan 2021
Externally published	Yes

Keywords

Glucose
Glycemic control
Hyperglycemia
Hypoglycemia
Insulin

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10.1016/B978-0-12-821776-4.00028-7

Cite this

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abstract = "Disruptions in blood glucose homeostasis are commonly observed in neuro-critically ill patients and are strongly associated with an increased risk of morbidity and mortality. Despite this association, there is currently a lack of consensus regarding the optimal target blood glucose concentration for these patients and how to best achieve this target. In this chapter, we discuss the pathophysiology of stress-induced hyperglycemia and review the evidence-based recommendations for glycemic control in neuro-critically ill patients. In recent years, aggressive insulin therapy regimens have failed to confer clear outcomes benefits over a more conventional insulin therapy approach and are associated with an increased risk of hypoglycemia. For these reasons, the current evidence supports the maintenance of blood glucose concentrations < 180mg/dL with a target blood glucose concentration between 140 and 180mg/dL.",

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AU - Gruenbaum, Benjamin F.

AU - Bilotta, Federico

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Glycemic control

Abstract

Keywords

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