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Current Diabetes Reports
Published in: Current Diabetes Reports 11/2019

01-11-2019 | Insulins | Hospital Management of Diabetes (A Wallia and JJ Seley, Section Editors)

Updates in Glycemic Management in the Hospital

Authors: Wasineenart Mongkolpun, Bruna Provenzano, Jean-Charles Preiser

Published in: Current Diabetes Reports | Issue 11/2019

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Abstract

Purpose of Review

To provide an update of glycemic management during metabolic stress related to surgery or critical illness.

Recent Findings

There is a clear association between severe hyperglycemia, hypoglycemia, and high glycemic variability and poor outcomes of postoperative or critically ill patients. However, the impressive beneficial effects of tight glycemic management (TGM) by intensive insulin therapy reported in one study were never reproduced. Hence, the recommendation of TGM is now replaced by more liberal blood glucose (BG) targets (< 180 mg/dL or 10 mM). Recent data support the concept of targeting individualized blood glucose (BG) values according to the presence of diabetes mellitus/chronic hyperglycemia, the presence of brain injury, and the time from injury.

Summary

A more liberal glycemic management goal is currently advised during metabolic stress and could be switched to individualized glycemic management once validated by prospective trials.
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Metadata
Title
Updates in Glycemic Management in the Hospital
Authors
Wasineenart Mongkolpun
Bruna Provenzano
Jean-Charles Preiser
Publication date
01-11-2019
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 11/2019
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-019-1274-7

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