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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 10, 2015; 6(5): 693-706
Published online Jun 10, 2015. doi: 10.4239/wjd.v6.i5.693
Published online Jun 10, 2015. doi: 10.4239/wjd.v6.i5.693
Management of critically ill patients with type 2 diabetes: The need for personalised therapy
Palash Kar, Adam M Deane, Discipline of Acute Care Medicine, Level 5, Eleanor Harrald Building, University of Adelaide, South Australia 5000, Australia
Palash Kar, Adam M Deane, Intensive Care Unit, Level 4, Emergency Services Building, Royal Adelaide Hospital, South Australia 5000, Australia
Karen L Jones, Michael Horowitz, Adam M Deane, Centre for Research Excellence, University of Adelaide, South Australia 5000, Australia
Karen L Jones, Michael Horowitz, Discipline of Medicine, Level 6, Eleanor Harrald Building, University of Adelaide, South Australia 5000, Australia
Author contributions: Kar P was involved in conception and design of manuscript, acquiring and interpretation of data and drafting and revising the manuscript for final submission; Jones KL and Horowitz M co-supervised Kar P and were involved in conception, design and coordination of the manuscript along with drafting and revising the manuscript; Deane AM supervised Kar P, and was involved in conception and design of manuscript, acquiring data, analysis and interpretation of data, and drafting and revising the manuscript for final submission; all authors read and approved the final manuscript.
Conflict-of-interest: The authors declare there are no non-financial competing interests. Horowitz M has participated in advisory boards and/or symposia for Novo/Nordisk, Sanofi-aventis, Novartis, Eli-Lily, Boehringer Ingelheim, AstraZeneca, Satlogen and Meyer Nutraceuticals.
Open-Access: 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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Palash Kar, Intensive Care Unit, Level 4, Emergency Services Building, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia. p_kar@hotmail.com
Telephone: +61-8-82224624
Received: December 24, 2014
Peer-review started: December 26, 2014
First decision: February 7, 2015
Revised: February 20, 2015
Accepted: April 1, 2015
Article in press: April 7, 2015
Published online: June 10, 2015
Peer-review started: December 26, 2014
First decision: February 7, 2015
Revised: February 20, 2015
Accepted: April 1, 2015
Article in press: April 7, 2015
Published online: June 10, 2015
Core Tip
Core tip: With diabetes increasing in prevalence, the optimal management of glycaemia in critically ill patients with pre-existing diabetes remains unknown. Recent data has highlighted therapeutic uncertainties specific to these patients with suggestions that targeted blood glucose concentrations may benefit from consideration of a patient’s premorbid glucose state. In patients with uncontrolled type 2 diabetes, it may be safer to target blood glucose concentrations between 10-14 mmol/L, however definitive studies of critically ill patients with poorly controlled diabetes are required. In contrast, in patients with CIAH, or those with well-controlled diabetes (HbA1c < 7.0) have data supporting a more conservative target (6-10 mmol/L).