Purpose of Review We reviewed the strategies associated with ICU, caregivers should define responses to interruption of hypoglycemia risk reduction among critically ill non-pregnant continuous carbohydrate exposure, incorporate transitioning adult patients. strategies upon initiation and interruption of IV insulin, define Recent Findings Hypoglycemia in the ICU has been associ- modifications of antihyperglycemic therapy in the presence of ated with increased mortality in a number of studies. Insulin worsening renal function or chronic kidney disease, and an- dosing and glucose monitoring rules, response to impending ticipate the effects traceable to other medications and sub- hypoglycemia, use of computerization, and attention to mod- stances. Institutional and system-wide quality improvement ifiable factors extrinsic to insulin algorithms may affect the efforts should assign priority to hypoglycemia prevention. risk for hypoglycemia. Recurring use of intravenous (IV) bo- . . . lus doses of insulin in insulin-resistant cases may reduce reli- Keywords Hypoglycemia Critical care Insulin protocol . . ance upon higher IV infusion rates. Insulin infusion Best practices Critical care protocols Introduction This article is part of the Topical Collection on Hospital Management of Diabetes The problem of hypoglycemia and its association with mor- * Susan Shapiro Braithwaite tality have dampened enthusiasm for strict
Current Diabetes Reports – Springer Journals
Published: Nov 2, 2017
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