Navigation Links
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 blood sugar (hypoglycemia), which can be deadly.

The Feb. 15 study also concluded that using intensive insulin therapy to significantly lower blood sugar levels isn't associated with greater improvements in health outcomes.

"The evidence isn't clear on what range of blood sugar is best, but 140 to 200 mg/dL seems to minimize the risk of hypoglycemia [in surgical or medical units]," said Qaseem. "We felt it was better to stick with a range that is a little bit higher."

Dr. Mary Korytowski, a professor of medicine at the University of Pittsburgh School of Medicine, and a member of the board of directors of the American Diabetes Association, said that intensive insulin management in medical and surgical units isn't the best way to manage blood sugar any more.

But, Korytowski said, "200 mg/dL is probably too high. The 2009 ADA/AACE guidelines recommend 180 mg/dL, which is consistent with postprandial numbers in diabetes care."

The problem is that if you set the target too high, those numbers may be even higher when someone starts giving insulin to bring those numbers down, she explained.

"These guidelines should not be interpreted to mean that glucose control isn't important for critically ill patients: It is. And it's important not to let the blood sugar get too high because of the risk of complications, like a higher risk of infection and fluid and electrolyte abnormalities," she said.

And, she added, that it's important to remember these guidelines give a range of options. "Managing blood sugar closer to the lower end is probably better," she concluded.

More information

Read about how illness can affect blood sugar levels in people with diabetes from the American Diabetes Association.

SOURCES: Amir Qaseem, M.D., Ph.D., director, clinical policy, medical education division, American College of Physicians, Philadelphia; Mary Korytkowski, M.D., professor, medicine, University of Pittsburgh School of Medicine, and member, board of directors, American Diabetes Association; Feb. 15, 2011, Annals of Internal Medicine


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Higher Levels of Blood Protein Linked to Lower Respiratory Risks
2. New Guidelines OK Pradaxa Blood Thinner as Option for Irregular Heartbeat
3. No Benefit to Lowering Blood Pressure in Acute Stroke: Study
4. Preliminary new blood test to detect Alzheimers disease uncovered
5. Need for Blood and Organ Donors Continues to Grow
6. Lead Exposure May Raise Blood Pressure in Pregnancy
7. Early infusion of donor T cells prevents graft versus host disease in blood cancer patients
8. Researchers Craft Blood Vessels for Heart, Kidney Patients
9. New nanoparticles make blood clots visible
10. Shoo fly: Catnip oil repels bloodsucking flies
11. Researchers discover root cause of blood vessel damage in diabetes
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
In-Hospital Blood Sugar Levels Should Be Higher: Report
(Date:3/29/2017)... ... March 29, 2017 , ... Dr. Angela Cotey, a noted general ... accepting new pediatric patients, with or without a referral. Dr. Cotey knows that ... orthodontic outcome and experience. When patients receive early treatment, they may achieve straight teeth ...
(Date:3/29/2017)... ... March 29, 2017 , ... ... for documenting and diagramming network and data center assets and audio-video devices has ... can request new equipment shapes for free and download shapes and stencils from ...
(Date:3/29/2017)... ... 29, 2017 , ... HealthCareMandA.com will host an important webinar — Home Health ... ET. A recording of the webinar will also be made available following its live ... hospice companies are still popular targets for healthcare investors. This highly fragmented sector bounced ...
(Date:3/29/2017)... Hollywood, CA (PRWEB) , ... March 29, 2017 , ... ... Northridge , is now offering laser dental treatments. Dental lasers are safe and ... Laser dentistry expands patients’ options and can improve the overall quality of care. , ...
(Date:3/29/2017)... PA (PRWEB) , ... March 29, 2017 , ... The ... W’80, WG’81, and Julie Taffet Moelis, W’81, have made a $10 million gift to ... deferred admission opportunity that will provide a pathway to a Wharton MBA for highly-qualified ...
Breaking Medicine News(10 mins):
(Date:3/29/2017)...  Maxor National Pharmacy Services, LLC ("Maxor"), a leading ... Leah Bailey as General Counsel.  Bailey will serve ... With more than 13 years of experience ... on health care, Bailey joins the Maxor team coming ... advised the PBM, Specialty, and Mail Order business areas ...
(Date:3/29/2017)... , March 29, 2017  Designers of primary cell ... solution size by 50% and extend battery life with ... management integrated circuit (PMIC) from Maxim Integrated Products, Inc. ... a low input voltage of just 0.7V for new ... Silver Oxide, as well as the more common Alkaline ...
(Date:3/29/2017)... Michigan , USA, March 29, 2017 ... Company that Cares by People magazine, in partnership with ... of 50 companies on the list. This list highlights ... that have succeeded in business while also demonstrating respect, ... the environment.  To determine the companies ...
Breaking Medicine Technology: