Carbohydrate Provision in the Era of Tight Glucose Control
Glycemic control in the critically ill patient has remained a controversial issue over the last decade. Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbid...
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| Veröffentlicht in: | Current gastroenterology reports 2011-08, Vol.13 (4), p.388-394 |
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| creator | Miller, Keith R. Lawson, Christy M. Smith, Vance L. Harbrecht, Brian G. |
| description | Glycemic control in the critically ill patient has remained a controversial issue over the last decade. Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbidity. Nutritional support has evolved into an additional area of critical care where appropriate practices have been associated with improved patient outcomes. Carbohydrate provision can impact blood-glucose levels, and the relationship between nutrition and glucose levels has become more complex in the era of improved glycemic control. This review discusses the controversy surrounding intensive-insulin therapy in the intensive care unit and explores the relationship with nutritional support, both in the enteral and parenteral form. Achieving realistic goals in both carbohydrate provision and glycemic control may improve patient outcome, and are not mutually exclusive practices. |
| doi_str_mv | 10.1007/s11894-011-0204-x |
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Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbidity. Nutritional support has evolved into an additional area of critical care where appropriate practices have been associated with improved patient outcomes. Carbohydrate provision can impact blood-glucose levels, and the relationship between nutrition and glucose levels has become more complex in the era of improved glycemic control. This review discusses the controversy surrounding intensive-insulin therapy in the intensive care unit and explores the relationship with nutritional support, both in the enteral and parenteral form. 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Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbidity. Nutritional support has evolved into an additional area of critical care where appropriate practices have been associated with improved patient outcomes. Carbohydrate provision can impact blood-glucose levels, and the relationship between nutrition and glucose levels has become more complex in the era of improved glycemic control. This review discusses the controversy surrounding intensive-insulin therapy in the intensive care unit and explores the relationship with nutritional support, both in the enteral and parenteral form. Achieving realistic goals in both carbohydrate provision and glycemic control may improve patient outcome, and are not mutually exclusive practices.</description><subject>Carbohydrates</subject><subject>Critical care</subject><subject>Diabetes</subject><subject>Dietary Carbohydrates - administration & dosage</subject><subject>Gastroenterology</subject><subject>Glucose</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - prevention & control</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - prevention & control</subject><subject>Illnesses</subject><subject>Immune system</subject><subject>Insulin resistance</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Kinases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Musculoskeletal system</subject><subject>Nutritional Support</subject><subject>Patients</subject><subject>Phosphorylation</subject><subject>Tumor necrosis factor-TNF</subject><issn>1522-8037</issn><issn>1534-312X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1LAzEQhoMotlZ_gBdZ8OBpNZPNJqkHQUqtQkEPPXgLyW623bLd1GS3tP_elNb6AZ5mYJ555-NF6BLwLWDM7zyA6NMYA8SYYBqvj1AX0oTGCZD3421OSCxwwjvozPs5DhDm7BR1CDBMMYUuuh8op-1skzvVmOjN2VXpS1tHZR01MxMNnYpsEU3K6ayJRlWbWW-iga0bZ6tzdFKoypuLfeyhydNwMniOx6-jl8HjOM4SQddxoalKgRHGCc4M14LmolA811jrIilypY3IBNUm1xz6NOd5oijps5TRTGmW9NDDTnbZ6oXJMxOGq0ouXblQbiOtKuXvSl3O5NSuZEI5pCkPAjd7AWc_WuMbuSh9ZqpK1ca2XgqeYgZMiEBe_yHntnV1OE6SPggensa3C8GOypz13pnisAtgufVF7nyRwRe59UWuQ8_VzyMOHV9GBIDsAB9K9dS479H_q34CBs-Zow</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Miller, Keith R.</creator><creator>Lawson, Christy M.</creator><creator>Smith, Vance L.</creator><creator>Harbrecht, Brian G.</creator><general>Current Science Inc</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201108</creationdate><title>Carbohydrate Provision in the Era of Tight Glucose Control</title><author>Miller, Keith R. ; Lawson, Christy M. ; Smith, Vance L. ; Harbrecht, Brian G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384x-fb4a51626720ce7b84d8fa7db0bbf3fdabe8c84bedb7194d7d3a4296564cab63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Carbohydrates</topic><topic>Critical care</topic><topic>Diabetes</topic><topic>Dietary Carbohydrates - administration & dosage</topic><topic>Gastroenterology</topic><topic>Glucose</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hyperglycemia - prevention & control</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - prevention & control</topic><topic>Illnesses</topic><topic>Immune system</topic><topic>Insulin resistance</topic><topic>Intensive care</topic><topic>Intensive Care Units</topic><topic>Kinases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Musculoskeletal system</topic><topic>Nutritional Support</topic><topic>Patients</topic><topic>Phosphorylation</topic><topic>Tumor necrosis factor-TNF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miller, Keith R.</creatorcontrib><creatorcontrib>Lawson, Christy M.</creatorcontrib><creatorcontrib>Smith, Vance L.</creatorcontrib><creatorcontrib>Harbrecht, Brian G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Current gastroenterology reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miller, Keith R.</au><au>Lawson, Christy M.</au><au>Smith, Vance L.</au><au>Harbrecht, Brian G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carbohydrate Provision in the Era of Tight Glucose Control</atitle><jtitle>Current gastroenterology reports</jtitle><stitle>Curr Gastroenterol Rep</stitle><addtitle>Curr Gastroenterol Rep</addtitle><date>2011-08</date><risdate>2011</risdate><volume>13</volume><issue>4</issue><spage>388</spage><epage>394</epage><pages>388-394</pages><issn>1522-8037</issn><eissn>1534-312X</eissn><abstract>Glycemic control in the critically ill patient has remained a controversial issue over the last decade. 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| subjects | Carbohydrates Critical care Diabetes Dietary Carbohydrates - administration & dosage Gastroenterology Glucose Humans Hyperglycemia Hyperglycemia - prevention & control Hypoglycemia Hypoglycemia - prevention & control Illnesses Immune system Insulin resistance Intensive care Intensive Care Units Kinases Medicine Medicine & Public Health Morbidity Mortality Musculoskeletal system Nutritional Support Patients Phosphorylation Tumor necrosis factor-TNF |
| title | Carbohydrate Provision in the Era of Tight Glucose Control |
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