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Type: Journal article
Title: Management of critically ill patients with type 2 diabetes: the need for personalised therapy
Author: Kar, P.
Jones, K.
Horowitz, M.
Deane, A.
Citation: World Journal of Diabetes, 2015; 6(5):693-706
Publisher: Baishideng Publishing
Issue Date: 2015
ISSN: 1948-9358
Statement of
Palash Kar, Karen L Jones, Michael Horowitz and Adam M Deane
Abstract: Critical illness in patients with pre-existing diabetes frequently causes deterioration in glycaemic control. Despite the prevalence of diabetes in patients admitted to hospital and intensive care units, the ideal management of hyperglycaemia in these groups is uncertain. There are data that suggest that acute hyperglycaemia in critically ill patients without diabetes is associated with increased mortality and morbidity. Exogenous insulin to keep blood glucose concentrations < 10 mmol/L is accepted as standard of care in this group. However, preliminary data have recently been reported that suggest that chronic hyperglycaemia may result in conditioning, which protects these patients against damage mediated by acute hyperglycaemia. Furthermore, acute glucose-lowering to < 10 mmol/L in patients with diabetes with inadequate glycaemic control prior to their critical illness appears to have the capacity to cause harm. This review focuses on glycaemic control in critically ill patients with type 2 diabetes, the potential for harm from glucose-lowering and the rationale for personalised therapy.
Keywords: Diabetes; critically ill; intensive care; management; personalised therapy
Rights: © The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: licenses/by-nc/4.0/
DOI: 10.4239/wjd.v6.i5.693
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