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Saturday, February 19, 2011

Too Tight Blood Sugar Control in Hospital may be Harmful

Posted by Dr Prahallad Panda on 9:07 PM Comments

A patient having his blood pressure taken by a...Image via WikipediaToo tight blood sugar control in hospitalized diabetic patients may not be required. It has been seen that blood sugar level within 180 to 200 milligrams% does not particularly affect the outcome of the patient.
Medical and surgical patients in the hospital are sometimes prone to hypoglycaemia mainly due to inadequate food intake following surgical procedures.
It should not be interpreted 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
This is according to American College of Physicians, 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.
Adopting this practice may reduce many hypoglycemic events in the hospital with intense insulin therapy.
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