Diabetes Treatment Review

Hypoglycemia management in critically ill patients

Nicole Meinel of the Diabetic Hypoglycemia Editorial Team

Diabetic Hypoglycemia Oct 2010, Volume 3, Issue 2: page 23-27

Abstract

Hypoglycemia in crtically ill patients may lead to adverse outcomes. This Treatment Review describes recent studies on methods used to measure and monitor blood glucose levels and on assessments of the risk factors associated with hypoglycemia and mortality in critically ill patients. Independent risk factors for hypoglycemia (blood glucose <60 mg/dl; <3.3mmol/l) were found to include having diabetes or undergoing intensive insulin therapy, while those for mortality included mechanical ventilation, medical illness and hypoglycemia. Recent data on other risks for hypoglycemia and critical illness include the use of glucose dehydrogenase pyrroloquinoline quinine test strips, which may record falsely elevated blood glucose levels, and contamination of arterial line sampling systems. It is important that healthcare providers are aware of these risks in order to implement effective prevention strategies.

Keywords: hypoglycemia, critical illness, tight glycemic control, intensive insulin therapy, continuous blood glucose monitoring, arterial line sampling, glucose dehydrogenase pyrroloquinoline quinone