Yoğun Bakımda Diabetes Mellitus Yönetimi
Özet
Diabetes mellitus (DM) yol açtığı morbidite ve mortalite nedeniyle yoğun bakım ünitelerinde (YBÜ) iyi yönetim gerektiren sorunlar arasında önemli bir yere sahiptir. Dahili ve cerrahi yoğun bakım ünitelerinde hiperglisemi ile YBÜ yatış süresinde ve mortalitede artış ile ilişkili kötü klinik sonuçlar bildirilmektedir. Yoğun bakım ünitelerinde hiperglisemi, hem bilinen DM tanısı olan hastalarda hem de daha önce normal glisemi profili olan hastalarda stres hiperglisemisi şeklinde ortaya çıkabilir. Hiperglisemi beraberinde artmış enfeksiyon riski, yara iyileşmesinde bozulma, çoklu organ yetmezliği risklerini de getirir. Bu nedenle YBÜ hastalarında tedavi başarısını arttırmak için glisemik kontrolün optimal şekilde sağlanması gereklidir.
Diabetes mellitus (DM) has an important place among the problems that require appropriate management in intensive care units (ICU). Poor clinical outcomes associated with hyperglycemia and increased ICU stay and mortality are reported in medical and surgical ICUs. Hyperglycemia can occur in both patients with a known diagnosis of DM and as stress hyperglycemia in patients with a previously normal glycemic profile in the ICU. Hyperglycemia also brings the risks of increase in infections, impaired wound healing, and multiple organ failure. Therefore, it is necessary to ensure optimal glycemic control to increase treatment success in ICU patients.
Referanslar
WHO (World Health Organisation). Fact sheets: Diabetes 2023. Erişim Adresi: https://www.who.int/news-room/fact-sheets/detail/diabetes (Erişim Tarihi: 15/05/2023).
Falciglia M, Freyberg RW, Almenoff PL, et al. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Critical Care Medicine. 2009;37(12):3001-3009. doi:10.1097/CCM.0b013e3181b083f7
Becker CD, Sabang RL, Nogueira Cordeiro MF, et al. Hyperglycemia in Medically Critically Ill Patients: Risk Factors and Clinical Outcomes. The American Journal of Medicine. 2020;133(10):e568-e574. doi:10.1016/j.amjmed.2020.03.012
Plummer MP, Finnis ME, Phillips LK, et al. Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness. PLoS One. 2016;11(11):e0165923. Published 2016 Nov 8. doi:10.1371/journal.pone.0165923
McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Critical Care Clinics. 2001;17(1):107-124. doi:10.1016/s0749-0704(05)70154-8
Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Practice & Research. Clinical Endocrinology & Metabolism. 2011;25(5):813-824. doi:10.1016/j.beem.2011.05.004
Zijlstra E, Heinemann L, Fischer A, et al. A Comprehensive Performance Evaluation of Five Blood Glucose Systems in the Hypo-, Eu-, and Hyperglycemic Range. Journal of Diabetes Science and Technology. 2016;10(6):1316-1323. Published 2016 Nov 1. doi:10.1177/1932296816668373
Louie RF, Tang Z, Sutton DV, et al. Point-of-care glucose testing: effects of critical care variables, influence of reference instruments, and a modular glucose meter design. Archives of Pathology & Laboratory Medicine. 2000;124(2):257-266. doi:10.5858/2000-124-0257-POCGT
Alshaer A, Badgheish BA, Alsadah ZH, et al. Comparing the accuracy of point-of-care with laboratory (capillary, venous, and arterial) blood glucose levels in critically ill patients with and without shock. BMC Research Notes. 2022;15(1):372. Published 2022 Dec 17. doi:10.1186/s13104-022-06256-0
Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-1131. doi:10.2337/dc09-9029
Agarwal S, Mathew J, Davis GM, et al. Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic. Diabetes Care. 2021;44(3):847-849. doi:10.2337/dc20-2219
Gothong C, Singh LG, Satyarengga M, et al. Continuous glucose monitoring in the hospital: an update in the era of COVID-19. Current Opinion in Endocrinology, Diabetes, and Obesity. 2022;29(1):1-9. doi:10.1097/MED.0000000000000693
Torres Roldan VD, Urtecho M, Nayfeh T, et al. A Systematic Review Supporting the Endocrine Society Guidelines: Management of Diabetes and High Risk of Hypoglycemia. The Journal of Clinical Endocrinology and Metabolism. 2023;108(3):592-603. doi:10.1210/clinem/dgac601
van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. The New England Journal of Medicine. 2001;345(19):1359-1367. doi:10.1056/NEJMoa011300
Preiser JC, Devos P, Ruiz-Santana S, et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Medicine. 2009;35(10):1738-1748. doi:10.1007/s00134-009-1585-2
NICE-SUGAR Study Investigators, Finfer S, Chittock DR, et al. Intensive versus conventional glucose control in critically ill patients. The New England Journal of Medicine. 2009;360(13):1283-1297. doi:10.1056/NEJMoa0810625
ElSayed NA, Aleppo G, Aroda VR, et al. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S267-S278. doi:10.2337/dc23-S016
Inzucchi SE. Management of diabetes mellitus in hospitalized patients. In: Post TW (ed.) UpToDate. Waltham (MA): UpToDate. (Erişim Tarihi: 12/05/2023).
Hsia E, Seggelke S, Gibbs J, et al. Subcutaneous administration of glargine to diabetic patients receiving insulin infusion prevents rebound hyperglycemia. The Journal of Clinical Endocrinology and Metabolism. 2012;97(9):3132-3137. doi:10.1210/jc.2012-1244
Morgan F, Kaufman ST. Acute diabetic emergencies, glycemic control, and hypoglycemia. In: Parrillo JE, Dellinger RP (eds.) Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia: Elsevier; 2019. p. 933-949.
Donihi AC, Raval D, Saul M, et al. Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2006;12(4):358-362. doi:10.4158/EP.12.4.358
Hung AM, Siew ED, Wilson OD, et al. Risk of Hypoglycemia Following Hospital Discharge in Patients With Diabetes and Acute Kidney Injury. Diabetes Care. 2018;41(3):503-512. doi:10.2337/dc17-1237
Dresler CM, Fortner JG, McDermott K, et al. Metabolic consequences of (regional) total pancreatectomy. Annals of Surgery. 1991;214(2):131-140. doi:10.1097/00000658-199108000-00007
Khazai NB, Hamdy O. Inpatient Diabetes Management in the Twenty-First Century. Endocrinology and Metabolism Clinics of North America. 2016;45(4):875-894. doi:10.1016/j.ecl.2016.06.013
Tsai SH, Lin YY, Hsu CW, Cheng CS, et al. Hypoglycemia revisited in the acute care setting. Yonsei Medical Journal. 2011;52(6):898-908. doi:10.3349/ymj.2011.52.6.898
Flory JH, Aleman JO, Furst J, et al. Basal Insulin Use in the Non-Critical Care Setting: Is Fasting Hypoglycemia Inevitable or Preventable?. Journal of Diabetes Science and Technology. 2014;8(2):427-428. doi:10.1177/1932296813520367
Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335-1343. doi:10.2337/dc09-9032
Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism: Clinical and Experimental. 2016;65(4):507-521. doi:10.1016/j.metabol.2015.12.007
Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma ve Eğitim Grubu. Diyabetin Akut Komplikasyonları. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi, ve İzlem Kılavuzu. Ankara: Çevrimiçi Yayın; 2022.p. 159-169.
Dhatariya KK; Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults-An updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabetic Medicine : A Journal of the British Diabetic Association. 2022;39(6):e14788. doi:10.1111/dme.14788
Mustafa OG, Haq M, Dashora U, Castro E, Dhatariya KK; Joint British Diabetes Societies (JBDS) for Inpatient Care Group. Management of Hyperosmolar Hyperglycaemic State (HHS) in Adults: An updated guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care Group. Diabetic Medicine : A Journal of the British Diabetic Association. 2023;40(3):e15005. doi:10.1111/dme.15005
Dhatariya K, Francisco JP, Umpierrez G. Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. In: Robertson RP (ed.) DeGroot’s Endocrinology Basic Science and Clinical Practice. 8th ed. Philadelphia: Elsevier; 2023. p. 641-654.
Referanslar
WHO (World Health Organisation). Fact sheets: Diabetes 2023. Erişim Adresi: https://www.who.int/news-room/fact-sheets/detail/diabetes (Erişim Tarihi: 15/05/2023).
Falciglia M, Freyberg RW, Almenoff PL, et al. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Critical Care Medicine. 2009;37(12):3001-3009. doi:10.1097/CCM.0b013e3181b083f7
Becker CD, Sabang RL, Nogueira Cordeiro MF, et al. Hyperglycemia in Medically Critically Ill Patients: Risk Factors and Clinical Outcomes. The American Journal of Medicine. 2020;133(10):e568-e574. doi:10.1016/j.amjmed.2020.03.012
Plummer MP, Finnis ME, Phillips LK, et al. Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness. PLoS One. 2016;11(11):e0165923. Published 2016 Nov 8. doi:10.1371/journal.pone.0165923
McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Critical Care Clinics. 2001;17(1):107-124. doi:10.1016/s0749-0704(05)70154-8
Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Practice & Research. Clinical Endocrinology & Metabolism. 2011;25(5):813-824. doi:10.1016/j.beem.2011.05.004
Zijlstra E, Heinemann L, Fischer A, et al. A Comprehensive Performance Evaluation of Five Blood Glucose Systems in the Hypo-, Eu-, and Hyperglycemic Range. Journal of Diabetes Science and Technology. 2016;10(6):1316-1323. Published 2016 Nov 1. doi:10.1177/1932296816668373
Louie RF, Tang Z, Sutton DV, et al. Point-of-care glucose testing: effects of critical care variables, influence of reference instruments, and a modular glucose meter design. Archives of Pathology & Laboratory Medicine. 2000;124(2):257-266. doi:10.5858/2000-124-0257-POCGT
Alshaer A, Badgheish BA, Alsadah ZH, et al. Comparing the accuracy of point-of-care with laboratory (capillary, venous, and arterial) blood glucose levels in critically ill patients with and without shock. BMC Research Notes. 2022;15(1):372. Published 2022 Dec 17. doi:10.1186/s13104-022-06256-0
Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-1131. doi:10.2337/dc09-9029
Agarwal S, Mathew J, Davis GM, et al. Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic. Diabetes Care. 2021;44(3):847-849. doi:10.2337/dc20-2219
Gothong C, Singh LG, Satyarengga M, et al. Continuous glucose monitoring in the hospital: an update in the era of COVID-19. Current Opinion in Endocrinology, Diabetes, and Obesity. 2022;29(1):1-9. doi:10.1097/MED.0000000000000693
Torres Roldan VD, Urtecho M, Nayfeh T, et al. A Systematic Review Supporting the Endocrine Society Guidelines: Management of Diabetes and High Risk of Hypoglycemia. The Journal of Clinical Endocrinology and Metabolism. 2023;108(3):592-603. doi:10.1210/clinem/dgac601
van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. The New England Journal of Medicine. 2001;345(19):1359-1367. doi:10.1056/NEJMoa011300
Preiser JC, Devos P, Ruiz-Santana S, et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Medicine. 2009;35(10):1738-1748. doi:10.1007/s00134-009-1585-2
NICE-SUGAR Study Investigators, Finfer S, Chittock DR, et al. Intensive versus conventional glucose control in critically ill patients. The New England Journal of Medicine. 2009;360(13):1283-1297. doi:10.1056/NEJMoa0810625
ElSayed NA, Aleppo G, Aroda VR, et al. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S267-S278. doi:10.2337/dc23-S016
Inzucchi SE. Management of diabetes mellitus in hospitalized patients. In: Post TW (ed.) UpToDate. Waltham (MA): UpToDate. (Erişim Tarihi: 12/05/2023).
Hsia E, Seggelke S, Gibbs J, et al. Subcutaneous administration of glargine to diabetic patients receiving insulin infusion prevents rebound hyperglycemia. The Journal of Clinical Endocrinology and Metabolism. 2012;97(9):3132-3137. doi:10.1210/jc.2012-1244
Morgan F, Kaufman ST. Acute diabetic emergencies, glycemic control, and hypoglycemia. In: Parrillo JE, Dellinger RP (eds.) Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia: Elsevier; 2019. p. 933-949.
Donihi AC, Raval D, Saul M, et al. Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2006;12(4):358-362. doi:10.4158/EP.12.4.358
Hung AM, Siew ED, Wilson OD, et al. Risk of Hypoglycemia Following Hospital Discharge in Patients With Diabetes and Acute Kidney Injury. Diabetes Care. 2018;41(3):503-512. doi:10.2337/dc17-1237
Dresler CM, Fortner JG, McDermott K, et al. Metabolic consequences of (regional) total pancreatectomy. Annals of Surgery. 1991;214(2):131-140. doi:10.1097/00000658-199108000-00007
Khazai NB, Hamdy O. Inpatient Diabetes Management in the Twenty-First Century. Endocrinology and Metabolism Clinics of North America. 2016;45(4):875-894. doi:10.1016/j.ecl.2016.06.013
Tsai SH, Lin YY, Hsu CW, Cheng CS, et al. Hypoglycemia revisited in the acute care setting. Yonsei Medical Journal. 2011;52(6):898-908. doi:10.3349/ymj.2011.52.6.898
Flory JH, Aleman JO, Furst J, et al. Basal Insulin Use in the Non-Critical Care Setting: Is Fasting Hypoglycemia Inevitable or Preventable?. Journal of Diabetes Science and Technology. 2014;8(2):427-428. doi:10.1177/1932296813520367
Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335-1343. doi:10.2337/dc09-9032
Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism: Clinical and Experimental. 2016;65(4):507-521. doi:10.1016/j.metabol.2015.12.007
Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma ve Eğitim Grubu. Diyabetin Akut Komplikasyonları. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi, ve İzlem Kılavuzu. Ankara: Çevrimiçi Yayın; 2022.p. 159-169.
Dhatariya KK; Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults-An updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabetic Medicine : A Journal of the British Diabetic Association. 2022;39(6):e14788. doi:10.1111/dme.14788
Mustafa OG, Haq M, Dashora U, Castro E, Dhatariya KK; Joint British Diabetes Societies (JBDS) for Inpatient Care Group. Management of Hyperosmolar Hyperglycaemic State (HHS) in Adults: An updated guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care Group. Diabetic Medicine : A Journal of the British Diabetic Association. 2023;40(3):e15005. doi:10.1111/dme.15005
Dhatariya K, Francisco JP, Umpierrez G. Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. In: Robertson RP (ed.) DeGroot’s Endocrinology Basic Science and Clinical Practice. 8th ed. Philadelphia: Elsevier; 2023. p. 641-654.
