Tight versus liberal blood-glucose control in the intensive care unit: special considerations for patients with diabetes
Stress hyperglycaemia, hypoglycaemia, and diabetes are common in critically ill patients and related to clinical endpoints. To avoid complications related to hypoglycaemia and hyperglycaemia, it is recommended to start insulin therapy for the majority of critically ill patients with persistent blood glucose concentrations higher than 10·0 mmol/L (>180 mg/dL), targeting a range of 7·8–10·0 mmol/L (140–180 mg/dL). However, management and evidence-based targets for blood glucose control are under debate, particularly for patients with diabetes.