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500 Hyperglycemia & Glycemic Control In ICU

Pic 2: Pathophysiology and complications of stress hyperglycemia

Elisabeth Donahey, et al Management of Hyperglycemia in Caritically Ill patients Pharmacy Practice news November 2013

In Early 2000, a blood glucose target of 80 to 110
mg/dL was used in many ICUs based on the results
of Leuven 1 Surgical Trial.

Acute myocardial infarction:
In diabetes mellitus, insulin glucose infusion in acute
myocardial infarction (DIGAM I), intensive treatment
by use of insulin infusion in MI resulted in 29% low-
er mortality compared to the conventionally treated
group.
A glucose target of 80 to 110mg/dL was found to
Hyperglycemia Linked to Mortality have a statistically significant benefit on intracranial
pressure and seizure incidence in 63 patients with
In 1997 Swedish authors published the results of isolated brain injury. However, a recent meta-analysis
the DIGAMI (Diabetes and Insulin-Glucose Infusion demonstrated that glucose control after a neurologic
in Acute Myocardial Infarction) trial, randomized to event such as ischemic stroke, aneurysmal subarach-
a blood glucose target of 126 to 196mg/dL, demon- noid hemorrhage, intraparenchymal hemorrhage, or
strated a 28% reduction in mortality.
traumatic brain injury does not yield a mortality ben-

GCDC 2017