Silva-Perez Livier Josefina, Benitez-Lopez Mario Alberto, Varon Joseph, Surani Salim
Livier Josefina Silva-Perez, Mario Alberto Benitez-Lopez, Department of Medicine, Autonomous University of Baja California, School of Medicine, Tijuana, BC 22260, Mexico.
World J Diabetes. 2017 Mar 15;8(3):89-96. doi: 10.4239/wjd.v8.i3.89.
Disorders of glucose homeostasis, such as stress-induced hypoglycemia and hyperglycemia, are common complications in patients in the intensive care unit. Patients with preexisting diabetes mellitus (DM) are more susceptible to hyperglycemia, as well as a higher risk from glucose overcorrection, that may results in severe hypoglycemia. In critically ill patients with DM, it is recommended to maintain a blood glucose range between 140-180 mg/dL. In neurological patients and surgical patients, tighter glycemic control (., 110-140 mg/d) is recommended if hypoglycemia can be properly avoided. There is limited evidence that shows that critically ill diabetic patients with a glycosylated hemoglobin levels above 7% may benefit from looser glycemic control, in order to reduce the risk of hypoglycemia and significant glycemic variability.
葡萄糖稳态紊乱，如应激性低血糖和高血糖，是重症监护病房患者常见的并发症。患有糖尿病（DM）的患者更容易出现高血糖，同时血糖过度纠正的风险也更高，这可能导致严重低血糖。对于患有DM的重症患者，建议将血糖维持在140 - 180 mg/dL之间。对于神经科患者和外科患者，如果能适当避免低血糖，建议进行更严格的血糖控制（即110 - 140 mg/dL）。有限的证据表明，糖化血红蛋白水平高于7%的重症糖尿病患者可能从较宽松的血糖控制中获益，以降低低血糖风险和显著的血糖波动。
