Anaesthesia | Patient specific populations | Endocrine problems in the critically ill 1

Endocrine problems in the critically ill 1
Session Overview
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This session contains a link to the BJA Education article

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CPD credit can be claimed for the time spent reading the article.

Endocrine problems in the critically ill 1: diabetes and glycaemic control. Elizabeth Kerr, Deborah et al. BJA Education, Volume 17, Issue 11, 370-376

• Dysglycaemia occurs frequently in critical illness, both in diabetic and in non-diabetic patients, often reflecting underlying disease severity
• Aggressive insulin therapy may be harmful and is associated with an increased incidence of severe hypoglycaemia; therefore, a pragmatic approach to glycaemic control is necessary
• Hypoglycaemia is common, and the clinical features are frequently masked in critical illness
• Immediate insulin therapy is not indicated in the hyperosmolar hyperglycaemic state (HHS) and may precipitate cardiovascular collapse
• A mixed picture of diabetic ketoacidosis and HHS can occur; treatment should be directed at the predominant element