Which statement about glucose targets in critically ill patients is true?

Which statement about glucose targets in critically ill patients is true?

• A. The target range is 140-180 mg/dL
• B. The target range is <110 mg/dL
• C. Glucose should be controlled to avoid polyuria and electrolyte disturbances
• D. The target range is 200-300 mg/dL

Answer: (A)

In critically ill patients, the aim is to keep blood glucose in a middle range to minimize the harms of both high glucose and excessive tightening of control. Large trials showed that trying to keep glucose very tight (below about 110 mg/dL) increases the risk of hypoglycemia and can worsen outcomes, including mortality. On the other hand, letting glucose stay very high (around 200–300 mg/dL) is linked with worse infections, organ dysfunction, and poorer prognosis. Therefore, a target around 140–180 mg/dL best balances these risks and is supported by major studies and guidelines. The idea of avoiding polyuria and electrolyte disturbances is related to the complications of hyperglycemia, but the primary reason for this target is improved patient outcomes. Implementing it involves regular glucose monitoring and insulin adjustments in the context of nutrition and illness severity.

In critically ill patients, the aim is to keep blood glucose in a middle range to minimize the harms of both high glucose and excessive tightening of control. Large trials showed that trying to keep glucose very tight (below about 110 mg/dL) increases the risk of hypoglycemia and can worsen outcomes, including mortality. On the other hand, letting glucose stay very high (around 200–300 mg/dL) is linked with worse infections, organ dysfunction, and poorer prognosis. Therefore, a target around 140–180 mg/dL best balances these risks and is supported by major studies and guidelines. The idea of avoiding polyuria and electrolyte disturbances is related to the complications of hyperglycemia, but the primary reason for this target is improved patient outcomes. Implementing it involves regular glucose monitoring and insulin adjustments in the context of nutrition and illness severity.