glucose

The recently published findings of the Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) (1) trial have dramatically changed clinician attitudes toward the achievement of euglycemia in intensive care unit (ICU) patients (1).

In our 30-bed general systems ICU at the University of Alberta Hospital, point-of-care glucose concentrations can be measured in 2 different ways: respiratory therapists measure arterial blood gases, hemoglobin, electrolytes, and glucose values with the Radiometer 800 blood gas system (BGA) and nurses measure arterial blood and capillary blood glucose with the LifeScan SureStep Flexx blood glucose meter (BGM).

Because many BGM systems provide artifactually high glucose concentrations in patients with low hematocrits (4), we graphed the BGM/BGA differences against hemoglobin that was proportional to hematocrit and measured by using the Radiometer analyzer.

AMSTERDAM -- Control of postmeal glucose values should be a focus of management for all patients with diabetes, according to new evidence-based guidelines from the International Diabetes Federation.

Released at a press briefing during the annual meeting of the European Association for the Study of Diabetes, the document concludes: "Regimens that target both fasting and postmeal glycaemia are needed to achieve optimal glucose control...

There is a growing awareness that postmeal glucose spikes are major contributors to overall glycemia as well as directly harmful, endocrinologist Paul S.

Since 2001, the AACE has recommended a 2-hour postmeal glucose value of 140 mg/dL or less for all diabetic patients, while the American Diabetes Association advocates a target of below 180 mg/dL at any nonfasting measurement.

Among those are the findings that treatment with medications that target postmeal plasma glucose reduces vascular events, and that targeting both postmeal and fasting plasma glucose is an important strategy for achieving optimal glycemic control.

* Two-hour postmeal plasma glucose should not exceed 7.8 mmol/L (140 mg/dL), as long as hypoglycemia is avoided.

Control of blood glucose can avoid the negative health consequences of diabetes mellitus (3); there thus is an ever increasing need for continuous, noninvasive glucose monitoring for people with diabetes mellitus.

A critical component of intensive diabetes management is accurate and frequent home glucose monitoring, but the current generation of home glucose meters are accurate only to [+ or -]15%, require a fingerstick for blood sampling, and must be carried everywhere with the patient.