TY - CHAP M1 - Book, Section TI - Controversies: Is Glucose Control Relevant? A1 - Bassily-Marcus, Adel A1 - Khachaturova, Inga A2 - Oropello, John M. A2 - Pastores, Stephen M. A2 - Kvetan, Vladimir PY - 1 T2 - Critical Care AB - Virtually all adult medical ICU patients experience at least 1 blood glucose value above the normal fasting level (110 mg/dL).1 The stress of critical illness promotes a state of insulin resistance which is characterized by increased hepatic gluconeogenesis and glycogenolysis, impaired peripheral glucose uptake, and higher circulating concentrations of insulin. There is upregulation of hepatic glucose production triggered by elevated levels of cytokines and counterregulatory hormones such as glucagon, cortisol, growth hormone, and catecholamines. These metabolic disturbances together with common ICU treatments such as corticosteroids, sympathomimetic agents, and glucose-containing infusions explain the frequently observed phenomenon of hyerglycemia irrespective of the disease, diabetes mellitus. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/15 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1136418426 ER -