Glycemic Control in Postoperative Patients in ICU (Comparative Study between Euglycemic Control and Mild Hyperglycemic Control in Patients Outcome)

Abstract

Abstract Background Hyperglycemia is common complication in postoperative patients admitted to intensive care units, whether a patient has a history of diabetes or not. Hyperglycemia has been associated with increased perioperative morbidity and mortality. Objective To compare between outcome of euglycemia and mild hyperglycemia in postoperative patients admitted to ICU. And achieving the optimal target range for blood glucose in postoperative patients. Patients and Methods We conducted our prospective study on 70 postoperative patients admitted to ICU with blood glucose above 180 mg/dl we managed all of them with intravenous insulin with 2 different blood glucose level targets. Group one with euglycemic control aimed blood glucose level between 110 gm/dl to 140 gm/dl. Group two with mild hyperglycemia aimed blood glucose level target between 140 gm/dl to 180 gm/dl. Results We found in our study that euglycemic control didn’t significantly reduce the postoperative complications and improve the patients outcome in comparison to the mild hyperglycemic group. We also found that there is a mild lower rates of complications in non diabetic patients on euglycemic control compared with those non diabetics treated with mild hypoglycemic targets. Conclusion In our prospective study to compare between effects of euglymic control versus mild hyperglycemia we found that there is no significant difference in patients outcomes between patients controlled at target range 110 gm/dl to 140 gm/dl in comparison to the controlled group between blood glucose range 140 gm/dl to 180 gm/dl in postoperative patients admitted to ICU However there is less complications rates in non diabetics with euglycemic control group in comparison to non diabetics in group two (mild hyperglycemia). The optimal target for blood glucose level is a wide range from 110 mg/dl up to 180 mg/dl.