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Hypoglycemia in the Critically Ill Patient

Metabolism and Pulmonary Divisions of the Department of Medicine, and the General Clinical Research Center and Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, MO

Philip E. Cryer, MD

Metabolism and Pulmonary Divisions of the Department of Medicine, and the General Clinical Research Center and Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, MO

Hypoglycemia is diagnosed convincingly when typical symptoms are associated with a low plasma glucose concentration and are relieved by glucose administration. It requires urgent treatment (usually with intravenous glucose in the hospital setting), diagnostic explanation, and long-term prevention. The latter is based upon an understanding of the pathogenesis of hypoglycemia in the affected patient. Postabsorptive (fasting) hypoglycemia is often caused by drugs (especially insulin, a sulfonylurea, or alcohol); it can also result from endogenous hyperinsulinism (insulinoma, autoimmune hypoglycemia), a non-β-cell tumor, hormonal deficiencies, or a variety of clinical syndromes including sepsis, cardiac, renal, and hepatic failure, and even inanition per se. Hypoglycemia is a treatable cause of acute morbidity. It is sometimes a cause of chronic morbidity and even mortality that could have been prevented.

Journal of Intensive Care Medicine, Vol. 1, No. 3, 149-155 (1986)
DOI: 10.1177/088506668600100305


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