Management of critically ill patients with diabetes

Table 1 Factors leading to hyperglycemia and hypoglycemia in critically ill patients

Hyperglycemia[65]	Hypoglycemia[66]
Release of stress hormones (glucagon, epinephrine, cortisol, and TNF-α)	Severe sepsis
Certain medications (exogenous glucocorticoids, vasopressors, lithium, and β-blockers)	Trauma
Overfeeding	DM
Intravenous dextrose	Prior insulin treatment
Parenteral nutrition	Prior glucocorticoid treatment
Persistent bed rest	Cardiovascular failure
Increased insulin resistance (DM type 2)	Intensive glucose control
Deficient insulin secretion (DM type 1)

DM: Diabetes mellitus; TNF: Tumor necrosis factor.