Krinsley James S, Fisher Molly
Director of Critical Care, Stamford Hospital, Stamford, CT; Clinical Professor of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
Hosp Pract (1995). 2012 Apr;40(2):31-5. doi: 10.3810/hp.2012.04.967.
Intensive monitoring of blood glucose levels and treatment of hyperglycemia in critically ill patients has become a standard of care over the past decade. Although diabetes is associated with a large burden of illness in outpatients, the "diabetes paradox" suggests that in patients admitted to intensive care units, the presence of diabetes as a comorbidity is not independently associated with increased risk of mortality. This review article 1) describes prospective trial and observational cohort literature addressing this issue, 2) addresses the potential mechanisms underlying the diabetes paradox, and 3) discusses implications for patient care and future research.
在过去十年中，对重症患者进行血糖水平的强化监测和高血糖治疗已成为一种护理标准。尽管糖尿病在门诊患者中与大量疾病负担相关，但“糖尿病悖论”表明，在入住重症监护病房的患者中，糖尿病作为一种合并症的存在与死亡率增加并无独立关联。这篇综述文章：1）描述了针对该问题的前瞻性试验和观察性队列研究文献；2）探讨了糖尿病悖论背后的潜在机制；3）讨论了对患者护理和未来研究的影响。
