Dysglycemia, including hyperglycemia, hypoglycemia, and glycemic variability, develops in most critically ill patients. Management can significantly impact outcomes and hinges on frequent, accurate glucose monitoring and effective insulin therapeutic strategies. Since the publication of the NICE-SUGAR and GLUCONTROL trials, glucose goals have been standardized for nearly all patients to intermediate levels (130-180 mg/dL). This one-size-fits-all approach has been increasingly challenged. For those without diabetes, even moderate hyperglycemia is associated with harm, including mortality. For those with poorly controlled diabetes, typical glucose targets may result in relative hypoglycemia and subsequent metabolic stress and potential harm. The move toward individualized patient glucose goals has been tempered by the risk of absolute hyperglycemia (with liberal goals), hypoglycemia (with tighter goals), and prior failures in achieving stated goals with current insulin algorithms. New technology may mitigate these risks and improve glycemic control. This session will address the physiologic rationale for, and unique risks of, individualized glucose goals, including liberalizing glucose goals in those with diabetes, and targeting tight physiologic glucose goals in those without diabetes who develop hyperglycemia. Speakers will compare and contrast the risk of acute/stress hyperglycemia with chronic hyperglycemia. The impact of relative hypoglycemia and glycemic variability will be integrated into a holistic approach to glucose targets in critically ill patients. Speakers will review newer technology including continuous glucose monitors and artificial pancreas devices in both outpatient and critical care settings for potential safe, individualized glycemic control.
- Provider:Society of Critical Care Medicine
- Activity Link: https://congress2024.sccm.org/aaStatic.asp?SFP=VFJVUUtHWFdAMTU3NjlAQ29uZ3Jlc3MgRGlnaXRhbA
- Start Date: 2024-01-21 06:00:00
- End Date: 2024-01-21 06:00:00
- Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
- MOC Credit Details: ABS - 1.0 Point; Credit Type(s): Accredited CME (ABS)
ABA - 1.0 Point; Credit Type(s): Lifelong Learning (ABA)
ABIM - 1.0 Point; Credit Type(s): Medical Knowledge (ABIM)
ABP - 1.0 Point; Credit Type(s): Lifelong Learning and Self-Assessment (ABP) - Commercial Support: No
- Activity Type: Enduring Material
- CME Finder Type: Online Learning
- Fee to Participate: Variable
- Measured Outcome: Learner Competence, Learner Knowledge
- Provider Ship: Directly Provided
- Registration: Open to all
- Specialty: Critical Care Medicine, Pediatric Critical Care Medicine, Surgical Critical Care