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World J Meta-Anal. Aug 31, 2019; 7(8): 399-405
Published online Aug 31, 2019. doi: 10.13105/wjma.v7.i8.399
Blood glucose control in the intensive care unit: Where is the data?
Sebastian Casillas, Edgar Jauregui, Salim Surani, Joseph Varon
Sebastian Casillas, Edgar Jauregui, Universidad Autonoma de Baja California, Campus Otay, Nueva, Mexicali 21100, Mexico
Salim Surani, Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Texas A and M University, Corpus Christi, TX 78414, United States
Joseph Varon, Acute and Continuing Care, The University of Texas Health Science Center at Houston, The University of Texas, Medical Branch at Galveston, United Memorial Medical Center/United General Hospital, Houston, TX 77030, United States
Author contributions: All authors have contributed to the preparation of manuscript, literature search and review for this minireview.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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/
Corresponding author: Salim Surani, BSc, FACC, FACP, FCCP, MD, Professor, Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Texas A and M University, 701 Ayers Street, Corpus Christi, TX 78414, United States. srsurani@hotmail.com
Telephone: +1-361-8857722 Fax: +1-361-8507563
Received: April 8, 2019
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
Processing time: 149 Days and 9.2 Hours
Abstract

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.

Keywords: Blood glucose control; Critical illness; Intensive care unit; Insulin therapy; Critical care

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.