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In-Hospital Blood Sugar Levels Should Be Higher: Report
Date:2/16/2011

By Serena Gordon
HealthDay Reporter

WEDNESDAY, Feb. 16 (HealthDay News) -- The American College of Physicians has released new guidelines recommending that doctors not attempt intensive insulin therapy designed to achieve normal blood sugar levels in patients in medical or surgical intensive care units.

These guidelines are for both people with diabetes and without the condition. The college recommends that doctors should maintain blood sugar levels between 140 and 200 milligrams per deciliter (mg/dL) for anyone in medical or surgical intensive care.

These recommendations are similar to the guidelines from the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE). However, those guidelines recommend that blood sugar levels should be kept below 180 mg/dL to reduce the risk of infection and other complications.

For reference, in a healthy person with type 2 diabetes, normal blood sugar levels would be between 70 mg/dL and 130 mg/dL before eating. And, even after eating (postprandial), the recommendation from the ADA is to keep blood sugar levels under 180 mg/dL.

"[High blood sugar] is a common finding in hospitalized patients, and it's associated with a lot of complications, like delayed healing, increased infection, cardiovascular events, you name it," said Dr. Amir Qaseem, director of clinical policy in the medical education division of the American College of Physicians.

"The prevailing thought in the past was that tightly controlling the blood sugar levels would reduce inflammation, clotting and other problems. But, there are also harms that are associated with lowering the blood glucose levels too much. [Low blood sugar] can be very dangerous," he explained.

Recent research, including a study in the Feb. 15 issue of the Annals of Internal Medicinehas found that the use of intensive insulin therapy comes with an increased risk of low blo
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