Managing hyperglycaemia in hospitalized patients

Vol.2, No.2, August 2012 Hyperglycaemia is a common, serious and costly health care problem in hospitalized patients. There is substantial observational evidence linking hyperglycaemia in critically ill patients (with and without diabetes) to higher rates of hospital complications, longer hospital stay, higher health care resource utilization, and greater hospital mortality (1,2). Although several cohort studies as well as early randomized clinical trials (RCTs) suggested that tight glucose control (80 to 110 mg/dL [4.4 to 6.1 mmol/L]) reduced hospital complications and mortality (3,4), this target has been difficult to achieve without increasing the risk for severe hypoglycaemia. In addition, recent RCTs in critically ill patients have failed to show a significant improvement in mortality or have even shown increased mortality risk with intensive glycaemic control (5-7).