Insulin: a wonder drug in the critically ill?
1 Associate Professor, Department of Intensive Care, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
2 Internist-Intensivist, Department of Intensive Care, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
3 Professor, Department of Cardiology, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Critical Care 2002, 6:102-105 doi:10.1186/cc1463
Published: 8 February 2002Abstract
Stress hyperglycaemia is a common event in acute critical illness. There is increasing evidence that maintaining normoglycaemia and treatment with insulin (or with glucose–insulin–potassium [GIK]), even in non-diabetic persons, is helpful in limiting organ damage after myocardial infarction, stroke, traumatic brain injury and other conditions, even though the conditions may be accompanied by insulin resistance. A landmark study now suggests that maintaining normoglycaemia with intensive insulin treatment in a heterogeneous population of critically ill patients decreases morbidity and mortality. The potential mechanisms that underlie such a beneficial effect are discussed.
