Published online Aug 31, 2019. doi: 10.13105/wjma.v7.i8.399
Peer-review started: April 8, 2019
First decision: August 2, 2019
Revised: August 13, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: August 31, 2019
Blood glucose control, including hyperglycemia correction, maintaining glucose at optimal level and avoiding hypoglycemia, is a challenge clinicians face every day in intensive care units (ICUs). If managed inadequately, its related mortality can increase. Prior to 2001, no relevant data from randomized, controlled studies assessing glucose control in the ICU were available. In the past 18 years, however, many clinical trials have defined criteria for managing abnormal blood glucose levels, as well as provided suggestions for glycemic monitoring. Point-of-care blood glucose monitors have become the preferred bedside technology to aid in glycemic management. In addition, in some institutions, continuous glucose monitoring is now available. Cost-effectiveness of adequate glycemic control in the ICU must be taken into consideration when addressing this complex issue. Newer types of glycemic monitoring may reduce nursing staff fatigue and shorten times for the treatment of hyperglycemia or hypoglycemia. There are a variety of glycemic care protocols available. However, not all ICU clinicians are aware of them. The following minireview describes some of these concepts.
Core tip: Blood glucose control in the intensive care unit has remained a controversial topic since 2001, with many clinical trials attempting to elucidate which method provides the best option in terms of cost-effectiveness and in providing good clinical outcomes. As technology plays an important role in this matter, this minireview compiles the many features of state-of-the-art glycemic monitoring in the intensive care unit and treatment strategies for blood glucose control.