PulmCrit (EMCrit)
PulmCrit Blogitorial - April 3, 2023 by Josh Farkas
… Where does this leave us clinically?
- The available evidentiary basis is shaky at best. It doesn't necessarily apply to our clinical practice.
- Insulin can definitely cause harm (hypoglycemic brain injury), whereas the benefits of tighter glycemic control are not robustly established.
- When in doubt we should be conservative with insulin, striving to avoid harm.
- We should avoid dogmatically applying any specific glycemic target to all patients. Every guideline recommends a specific target for glycemic control, but ironically these guidelines are not even consistent with each other