[Hyperglycaemia during hospitalisation]

Abstract

Patients who are admitted to an intensive care unit for 3 days or longer have an increased survival rate if their blood-glucose levels are strictly controlled by means of intensive insulin therapy. This is true of patients admitted for either surgical or non-surgical indications. For patients undergoing cardiac surgery, strict peri- and postoperative glycaemic control lowers the postoperative complication rate and possibly also mortality. Patients suffering from an acute myocardial infarction, and possibly also patients with acute ischaemic stroke, are likely to benefit from strict glycaemic control. The value of treating hyperglycaemia in other patient groups has not been established. The workload on the nursing staff and the risk of prolonged and serious hypoglycaemia are the most important disadvantages of strict glycaemic control. The optimal duration of strict glycaemic control and the precise target range are not well defined and may well differ per patient group.