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应激性高血糖:后果与管理

Stress-Induced Hyperglycemia: Consequences and Management.

作者信息

Vedantam Deepanjali, Poman Devyani S, Motwani Lakshya, Asif Nailah, Patel Apurva, Anne Krishna Kishore

机构信息

Internal Medicine, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, IND.

Research, Smolensk State Medical University, Smolensk, RUS.

出版信息

Cureus. 2022 Jul 10;14(7):e26714. doi: 10.7759/cureus.26714. eCollection 2022 Jul.

Abstract

Hyperglycemia during stress is a common occurrence seen in patients admitted to the hospital. It is defined as a blood glucose level above 180mg/dl in patients without pre-existing diabetes. Stress-induced hyperglycemia (SIH) occurs due to an illness that leads to insulin resistance and decreased insulin secretion. Such a mechanism causes elevated blood glucose and produces a complex state to manage with external insulin. This article compiles various studies to explain the development and consequences of SIH in the critically ill that ultimately lead to an increase in mortality while also discussing the dire impact of SIH on certain acute illnesses like myocardial infarction and ischemic stroke. It also evaluates multiple studies to understand the management of SIH with insulin and proper nutritional therapy in the hospitalized patients admitted to the Intensive care unit (ICU) alongside the non-critical care unit. While emphasizing the diverse effects of improper control of SIH in the hospital, this article elucidates and discusses the importance of formulating a discharge plan due to an increased risk of type 2 diabetes in the recovered.

摘要

应激期间的高血糖在入院患者中很常见。对于既往无糖尿病的患者,其定义为血糖水平高于180mg/dl。应激性高血糖(SIH)是由导致胰岛素抵抗和胰岛素分泌减少的疾病引起的。这种机制会导致血糖升高,并产生一种难以通过外源性胰岛素控制的复杂状态。本文汇总了各项研究,以解释危重症患者中SIH的发生发展及后果,这些最终会导致死亡率增加,同时还讨论了SIH对某些急性疾病如心肌梗死和缺血性中风的严重影响。本文还评估了多项研究,以了解在重症监护病房(ICU)和非重症监护病房住院的患者中,使用胰岛素和适当营养疗法对SIH的管理。在强调医院中SIH控制不当的多种影响时,本文阐明并讨论了由于康复患者患2型糖尿病风险增加而制定出院计划的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/517d/9360912/0d59aacb83ec/cureus-0014-00000026714-i01.jpg

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