Perioperative hyperglycemia in critically ill surgery patients increases the risk of postoperative infection (POI), which is a common, and often costly, surgical complication. Hyperglycemia is associated with abnormalities in leukocyte function, including granulocyte adherence, impaired phagocytosis, delayed chemotaxis, and depressed bactericidal capacity. These leukocyte deficiencies are the c...

OBJECTIVE To assess glycemic control, the degree of control of cardiovascular risk factors, and treatment schemes used in patients with type 1 diabetes mellitus (T1DM) in Castilla-La Mancha (Spain). PATIENTS AND METHODS A cross-sectional, multicenter study on adult patients with T1DM seen at outpatient endocrinology clinics for 12 months (from September 2009 to August 2010). Diabetes duration...

BACKGROUND We investigated whether intensive glycemic control, combination therapy for dyslipidemia, and intensive blood-pressure control would limit the progression of diabetic retinopathy in persons with type 2 diabetes. Previous data suggest that these systemic factors may be important in the development and progression of diabetic retinopathy. METHODS In a randomized trial, we enrolled 10...

OBJECTIVE The goal of this research is to demonstrate that well-regulated glycemia is beneficial to patient outcome, regardless of how it is achieved. METHODS This analysis used data from 1701 patients from 2, independent studies. Glycemic outcome was measured using cumulative time in band (cTIB), calculated for 3 glycemic bands and for threshold values of t = 0.5, 0.6, 0.7, and 0.8. For each...

INTRODUCTION Hyperglycemia is common in critically ill patients and is associated with increased morbidity and mortality. Strict glycemic control improves outcomes in some adult populations and may have similar effects in children. While glycemic control has become standard care in adults, little is known regarding hyperglycemia management strategies used by pediatric critical care practitioner...

A classic report by T. Franklin Williams et al. (1) in 1967 documented glaring deficiencies in diabetes care that went largely uncorrected for the next 30 years. It is only in the last 10 years that we have seen substantial and sustained improvement in basic aspects of care such as glycemic control, blood pressure control, and lipid control (2). Since 1995, there have been substantial and susta...

OBJECTIVE The Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus (VA CSDM) was a multicenter randomized prospective study of 153 male type 2 diabetic patients to assess the ability to sustain clinically significant glycemic separation between intensive and standard treatment arms. A trend toward an excess of combined cardiovascular events in the intensive treatment arm of this trial...

OBJECTIVE Glycemic control in the critically ill intensive care unit (ICU) patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED) patients in a small pilot trial. METHODS Adult non-trauma, non-pregnant ED patients presenting to a university tertiary referral center and identified as c...

BACKGROUND/AIMS Based on the results of well designed clinical studies, intensive insulin therapy has been established to improve glycemic control in newly diagnosed diabetes. However, discrepancies exist between the findings of clinical trials and experiences in general practice. Furthermore, the efficacy of an early insulin therapy (EIT) - commonly used in general practice - on long-term glyc...

The recent demonstration (1–3) of the benefits of intensive glycemic control in hospitalized patients has renewed interest in inpatient management of diabetes. Poor glycemic control is a marker for poor quality of hospital care (4), as well as an important safety issue: insulin is one of five medications most associated with inpatient medication errors (5,6). Moreover, many hospitals continue t...