Glycemic control in the burn intensive care unit: Focus on the role of anemia in glucose measurement

Elizabeth A. Mann, Alejandra G. Mora, Heather F. Pidcoke, Steven E. Wolf, Charles E. Wade

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Glycemic control with intensive insulin therapy (IIT) has received widespread adoption secondary to findings of improved clinical outcomes and survival in the burn population. Severe burn as a model for trauma is characterized by a hypermetabolic state, hyperglycemia, and insulin resistance. In this article, we review the findings of a burn center research facility in terms of understanding glucose management. The conferred benefits from IIT, our findings of poor outcomes associated with glycemic variability, advantages from preserved diurnal variation of glucose and insulin, and impacts of glucometer error and hematocrit correction factor are discussed. We conclude with direction for further study and the need for a reliable continuous glucose monitoring system. Such efforts will further the endeavor for achieving adequate glycemic control in order to assess the efficacy of target ranges and use of IIT.

Original languageEnglish (US)
Pages (from-to)1319-1329
Number of pages11
JournalJournal of Diabetes Science and Technology
Volume3
Issue number6
DOIs
StatePublished - Nov 2009

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Keywords

  • Artificial pancreas
  • Burn
  • Computer decision support
  • Continuous glucose monitor
  • Diurnal variation
  • Glucometer
  • Glucose variability
  • Hematocrit effect
  • Hypoglycemia
  • Intensive insulin therapy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Biomedical Engineering

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