Elevated blood glucose due to critical illness ("stress hyperglycemia") is seen in most intensive care unit patients. The elevated blood glucose has detrimental effects on the body through several different mechanisms. Clinicians must balance the risks of stress hyperglycemia versus the risk of dangerous low blood glucose values ("hypoglycemia").

GLUCOSE CONTROL

The large NICE-SUGAR study showed that normalizing blood glucose is not safe with the current technology. Most ICUs that focus on blood glucose control either use inaccurate point-of-care glucometers or accurate and infrequent or time-consuming blood gas analyses.

GlucoSet's sensors is unique because of it delivers high accuracy, rapid measurements and high sensitivity in the hypoglycemic range. GlucoSet is focused on developing products that fit into the existing workflow of nurses and physicians, maximizing the acceptance of new technology. 

 

“Quite simply, intermittent monitoring is not up to the task ... We now have abundant data demonstrating that this cannot be accomplished safely or effectively by using meters, strips and blood gas analyzers”
— James S. Krinsley, Director of Critical Care at Stamford Hospital and Professor of medicine at Columbia University

REDUCED MORTALITY

Several studies have shown mortality is higher for intensive care unit patients that have blood glucose levels outside of the normal range (80-110 mg/dl), and this effect is strongest in non-diabetic patients (figure below from Kosiborod et al.).

glucose_mortality_dots.png

REDUCED COMPLICATIONS

Normalizing the blood glucose reduces the risk of renal failure and sepsis, a very dangerous condition for Intensive Care Unit patients. As with mortality, the risk reduction is larger for non-diabetic patients.

 

SAVED COSTS

A single case of sepsis on average costs hospitals over $20 000 and the average cost per day of stay is $1 500 in direct costs for the hospital. A reduction in the incidence of sepsis and length of stay thus has a direct impact on costs.  

 

References

  • Van Den Berghe, Greet, et al. "Intensive insulin therapy in critically ill patients." New England journal of medicine 345.19 (2001): 1359-1367.
  • Kosiborod, Mikhail, et al. "Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction implications for patients with and without recognized diabetes." Circulation 111.23 (2005): 3078-3086.
  • Egi, Moritoki, Simon Finfer, and Rinaldo Bellomo. "Glycemic Control in the ICUGlycemic Control in the ICU." CHEST Journal 140.1 (2011): 212-220.
  • Cook, Curtiss B., Daniel J. Potter, and Gail L. Kongable. "Characterizing glucose changes antecedent to hypoglycemic events in the intensive care unit." Endocrine Practice 18.3 (2012): 317-324.
  • Bilotta, Federico, and Giovanni Rosa. "Glycemia management in critical care patients." World journal of diabetes 3.7 (2012): 130.
  • Barsanti, Mary C., and Keith F. Woeltje. "Infection prevention in the intensive care unit." Infectious disease clinics of north America 23.3 (2009): 703-725.
  • Lagu, Tara, et al. "What is the best method for estimating the burden of severe sepsis in the United States?." Journal of Critical Care 27.4 (2012): 414-e1.
  • Krinsley, James S. "Glycemic control in the critically ill-3 domains and diabetic status means one size does not fit all!." Critical care 17.2 (2013): 131.