Skip to main content
SpringerLink
Log in

Stress Hyperglycemia

  • Chapter
  • First Online:
The Stress Response of Critical Illness: Metabolic and Hormonal Aspects

  • 1377 Accesses

Abstract

The understanding and management of stress hyperglycemia has dramatically changed since 2001. In addition to the development of insulin resistance, stress hyperglycemia is characterised by a poorly inhibitable endogenous production of glucose leading to a severe hyperglycemia. The toxicity of hyperglycemia have been supported by numerous association studies, which reported strong correlations between the magnitude of hyperglycemia and poor outcome. However, tight glycemic control by intensive insulin therapy has not been improved outcomes in most interventional studies and is currently not recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dungan KM, Braithwaite SS, Preiser JC (2009) Stress hyperglycaemia. Lancet 23:1798–1807

    Article  Google Scholar 

  2. Van den Berghe G, Wouters P, Weekers F et al (2001) Intensive insulin therapy in the critically ill patients. N Engl J Med 345:1359–1367

    Article  PubMed  Google Scholar 

  3. Van den Berghe G, Wilmer A, Hermans G et al (2006) Intensive insulin therapy in the medical ICU. N Engl J Med 3545:449–461

    Article  Google Scholar 

  4. Arabi YM, Dabbagh OC, Tamin HM et al (2008) Intensive versus conventional insulin therapy: a randomized controlled trial in medical and surgical critically ill patients. Crit Care Med 36:3190–3197

    Article  CAS  PubMed  Google Scholar 

  5. De la Rosa GC, Donado JH, Restrepo AH et al (2008) Strict glycaemic control in patients hospitalized in a mixed medical and surgical intensive care unit: a randomized clinical trial. Crit Care 12:R120

    Article  Google Scholar 

  6. Brunkhorst FM, Engel C, Bloos F et al (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis? N Engl J Med 358:125–139

    Article  CAS  PubMed  Google Scholar 

  7. Preiser JC, Devos P, Ruiz-Santana S et al (2009) A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med 35:1738–1748

    Article  CAS  PubMed  Google Scholar 

  8. NICE-SUGAR Study Investigators, Finfer S, Chittock DR et al (2009) Intensive versus conventional glucose control in critically ill patients. N Engl J Med 360:1283–1297

    Google Scholar 

  9. Marik P, Preiser JC (2010) Toward understanding tight glycemic control in the ICU: a systematic review and metaanalysis. Chest 137:544–551

    Article  CAS  PubMed  Google Scholar 

  10. Lena D, Kalfon P, Preiser JC, Ichai C (2011) Glycemic control in the intensive care unit and during the postoperative period. Anesthesiology 114:438–444

    Article  PubMed  Google Scholar 

  11. Marik PE, Bellomo R (2013) Stress hyperglycemia: an essential survival response! Crit Care 17:305

    Article  PubMed  PubMed Central  Google Scholar 

  12. Preiser JC, Ichai C, Orban JC, Groeneveld AB (2014) Metabolic response to the stress of critical illness. Br J Anaesth 113:945–954

    Article  PubMed  Google Scholar 

  13. Brownlee M (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414:813–820

    Article  CAS  PubMed  Google Scholar 

  14. Bagry HS, Raghavendran S, Carli F, Phil M (2008) Metabolic syndrome and insulin resistance. Perioperative considerations. Anesthesiology 108:506–523

    Article  CAS  PubMed  Google Scholar 

  15. Sicardi SZ, Rodhe P, Hahn G (2006) Progressive decrease in glucose clearance during surgery. Acta Anaesthesiol Scand 50:848–854

    Article  Google Scholar 

  16. Krinsley JS (2004) Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc 79:992–1000

    Article  PubMed  Google Scholar 

  17. Finney SJ, Zekveld C, Elia A, Evans TW (2003) Glucose control and mortality in critically ill patients. JAMA 290:2041–2047

    Article  CAS  PubMed  Google Scholar 

  18. Falciglia M, Freyberg RW, Almenoff PL, D’Alessio DA, Render ML (2009) Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Crit Care Med 37:1–9

    Article  Google Scholar 

  19. Badawi O, Waite MD, Fuhrman SA, Zuckerman IH (2012) Association between intensive care unit-acquired dysglycemia and in-hospital mortality. Crit Care Med 40:3180–3188

    Article  PubMed  Google Scholar 

  20. Furnary AP, YingSing W (2006) Eliminating the diabetic disadvantage: the Portland Diabetic Project. Semin Thor Cardiovasc Surg 18:302–308

    Article  Google Scholar 

  21. D’Alessandro C, Leprince P, Golmard JL et al (2007) Strict glycemic control reduces EuroSCORE expected mortality in diabetic patients undergoing myocardial revascularization. J Thorac Cardiovasc Surg 134:29–37

    Article  PubMed  Google Scholar 

  22. Ouattara A, Lecompte P, Le Manach Y et al (2005) Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients. Anesthesiology 103:687–694

    Article  CAS  PubMed  Google Scholar 

  23. Krinsley JS, Preiser JC (2015) Time in blood glucose range 70 to 140 mg/dl >80% is strongly associated with increased survival in non-diabetic critically ill adults. Crit Care 19:179

    Article  PubMed  PubMed Central  Google Scholar 

  24. Egi M, Bellomo R, Stachowski E, French CJ, Hart GK, Hegarty C, Bailey M (2008) Blood glucose concentration and outcome of critical illness: the impact of diabetes. Crit Care Med 36:2249–2255

    Article  CAS  PubMed  Google Scholar 

  25. Rady MY, Johnson DJ, Patel BM, Larson JS, Helmers RA (2005) Influence of individual characteristics on outcome of glycemic control in intensive care unit patients with or without diabetes mellitus. Mayo Clin Proc 80:1558–1567

    Article  PubMed  Google Scholar 

  26. Kosiborod M, Rathore SS, Inzucchi SE, Masoudi FA, Wang Y, Havranek EP, Krumholz HM (2005) Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation 111:3078–3086

    Article  CAS  PubMed  Google Scholar 

  27. Van den Berghe G, Wilmer A, Milants I et al (2006) Intensive insulin therapy in mixed medical/surgical intensive care units: benefit versus harm. Diabetes 55:3151–3159

    Article  PubMed  Google Scholar 

  28. Plummer MP, Bellomo R, Cousins CE et al (2014) Dysglycaemia in the critically ill and the interaction of chronic and acute glycaemia with mortality. Intensive Care Med 40:973–980

    Article  CAS  PubMed  Google Scholar 

  29. Moghissi SE, Korythowski MT, DiNardo M et al (2009) American Association of clinical endocrinologists and American Diabetes Association consensus statement on inpatient glycaemic control. Endocr Pract 15:1–17

    Article  Google Scholar 

  30. Ichai C, Preiser JC, on behalf of the Steering Committee, the Expert panel (2010) International recommendations for glucose control in adult non diabetic critically ill patients. Crit Care 14:R166

    PubMed  PubMed Central  Google Scholar 

  31. Jacobi J, Bircher N, Krinsley J et al (2012) Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med 40:3251–3276

    Article  PubMed  Google Scholar 

  32. Finfer S, Wernerman J, Preiser JC et al (2013) Clinical review: consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults. Crit Care 17:229

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, 808 route de Lennik, Brussels, B-1070, Belgium

    Jean-Charles Preiser MD, PhD, Aurélie Thooft MD & Rafael Machado Tironi MD

Authors
  1. Jean-Charles Preiser MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aurélie Thooft MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rafael Machado Tironi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Charles Preiser MD, PhD .

Editor information

Editors and Affiliations

  1. Brussels, Belgium

    Jean-Charles Preiser

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Preiser, JC., Thooft, A., Tironi, R.M. (2016). Stress Hyperglycemia. In: Preiser, JC. (eds) The Stress Response of Critical Illness: Metabolic and Hormonal Aspects. Springer, Cham. https://doi.org/10.1007/978-3-319-27687-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27687-8_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27685-4

  • Online ISBN: 978-3-319-27687-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation