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Review
. 2020 May;14(3):553-559.
doi: 10.1177/1932296820905581. Epub 2020 Feb 11.

Accuracy of Blood Glucose Measurement and Blood Glucose Targets

Gert-Jan Eerdekens  1   2 , Steffen Rex  1   3 , Dieter Mesotten  2   4
Affiliations
Review

Accuracy of Blood Glucose Measurement and Blood Glucose Targets

Gert-Jan Eerdekens et al. J Diabetes Sci Technol. 2020 May.

Abstract

Background: To summarize new evidence regarding the methodological aspects of blood glucose control in the intensive care unit (ICU).

Methods: We reviewed the literature on blood glucose control in the ICU up to August 2019 through Ovid Medline and Pubmed.

Results: Since the publication of the Leuven studies, the benefits of glycemic control have been recognized. However, the methodology of blood glucose control, notably the blood glucose measurement accuracy and the insulin titration protocol, plays an important but underestimated role. This may partially explain the negative results of the large, pragmatic multicenter trials and made everyone realize that tight glycemic control with less-frequent glucose measurements on less accurate blood glucose meters is neither feasible nor advisable in daily practice. Blood gas analyzers remain the gold standard. New generation point-of-care blood glucose meters may be an alternative when using whole blood of critically ill patients in combination with a clinically validated insulin dosing algorithm.

Conclusion: When implementing blood glucose management in an ICU one needs to take into account the interaction between aimed glycemic target and blood glucose measurement methodology.

Keywords: blood glucose control; blood glucose level; intensive care unit; monitoring; tight glycemic control.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
J-shaped curve showing negative effects for both hypoglycemia and hyperglycemia.
See this image and copyright information in PMC

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MeSH terms