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:6/23/2017)... ... , ... The Military Officers Association of America (MOAA) announced its support for ... Marine Col. Thomas G. Bowman. , Bowman currently serves as the staff director for ... the issues and challenges veterans face with the VA. Following a 30-year career of ...
(Date:6/23/2017)... ... June 23, 2017 , ... Military Connection friend ... entry to the JFK Virgin Atlantic lounge. , Bensko is no stranger to ... years ago, Bensko dedicated her life to supporting our wounded veterans. A world-class photographer, ...
(Date:6/23/2017)... ... , ... Goodcents Deli Fresh Subs today announced the opening of a new ... St. Topeka, Kan. 66604 (near 21st and Gage). It is owned and operated by ... locations in the Topeka and Bonner Springs, Kan. area. , “Goodcents has such ...
(Date:6/23/2017)... ... June 23, 2017 , ... Ensuring meat ... new videos highlight the importance of correctly using a meat thermometer. The videos ... done extensive research on consumer food safety habits. Dr. Bruhn explains the variety ...
(Date:6/23/2017)... ... ... 21 Middle East and South Asia Leaders Selected as Eisenhower Fellows , ... in 11 countries across the Middle East and South Asia to embark on a ... and ideas with the leading minds in their fields. , For the first ...
Breaking Medicine News(10 mins):
(Date:6/5/2017)... The Cincinnati location of ... (NYSE: DPLO), has been awarded a Top Workplaces 2017 ... Results are based on an employee survey administered by WorkplaceDynamics, ... improvement. The survey measures several aspects of workplace culture, including ... ...
(Date:5/30/2017)... 2017 DarioHealth Corp. (NASDAQ: DRIO), a leading global digital ... that it will be presenting at the 7th annual LD Micro ... Erez Raphael , CEO, of DarioHealth will be giving the presentation ... on June 6th & 7th, 2017 at the Luxe Sunset Bel ... micro-cap space. About LD Micro ...
(Date:5/26/2017)... May 25, 2017  In response to the opioid ... Direct Relief is working with Pfizer to make up ... no cost to community health centers, free and charitable ... "Pfizer has a long-standing commitment to ... ensuring patient safety through educational activities," said Caroline ...
Breaking Medicine Technology: