Stress Hyperglycemia During Surgery and Anesthesia: Pathogenesis and Clinical Implications

Abstract

Numerous studies have demonstrated an association between hyperglycemia in the perioperative period and adverse clinical outcomes. Many patients who experience hyperglycemia while hospitalized do not have a known history of diabetes and experience a transient phenomenon often described as "stress hyperglycemia" (SH). We discuss the epidemiology and pathogenesis of SH as well as evidence to date regarding predisposing factors and outcomes. Further research is needed to identify the long-term sequelae of SH as well as perioperative measures that may modulate glucose elevations and optimal treatment strategies.

Keywords: Critical illness; Inpatient diabetes; Insulin; Insulin resistance; Perioperative glucose management; Stress hyperglycemia.