Insulin Therapy for Hyperglycemia Management in Critically Ill Patients

Hyperglycemia is associated with increased morbidity and mortality in critically ill patients and requires treatment; however, hypoglycemia is also detrimental to patients and must be avoided. Maintaining blood glucose between 140 - 180 mg/dL for critically ill patients improves outcomes. Very frequent glucose monitoring and adjustment of intravenous insulin infusion remains the standard of care to reach blood glucose goals but is also labor intensive. Emerging technology for continuous glucose monitoring that may include notifications or automated communication with an insulin delivery system may improve the maintenance of blood glucose in range and avoid hypoglycemia and hyperglycemia.