Safe Utilization of Hyperglycemia Management in the ICU

Critically ill patients admitted to intensive care units (ICUs) often present with multiple medical or surgical problems requiring a high level of care. In addition to a patient's underlying illness, a number of known risk factors can predispose patients to episodes of hyperglycemia as well as hypoglycemia. The concept of glycemic control and its implication on morbidity and mortality has been well-described, along with the potential risks. Conflicting study results have complicated implementing universal methods for optimal glycemic control in the ICUs. There are many factors to consider when implementing intensive glycemic control, including reliability of point-of-care testing for glucose measurement, healthcare resources, types of protocols and appropriate target ranges. It is important that clinicians fully understand the risks and benefits of glucose management in the ICU setting to safely administer this potentially beneficial therapy.