Groeneveld, et al. (2002). Insulin: a wonder drug in the critically ill?

[Wise Young]

• Johan Groeneveld A, Beishuizen A and Visser FC (2002). Insulin: a wonder drug in the critically ill? Crit Care. 6 (2): 102-105. Summary: Stress hyperglycaemia is a common event in acute critical illness. There is increasing evidence that maintaining normoglycaemia and treatment with insulin (or with glucose-insulin-potassium [GIK]), even in non-diabetic persons, is helpful in limiting organ damage after myocardial infarction, stroke, traumatic brain injury and other conditions, even though the conditions may be accompanied by insulin resistance. A landmark study now suggests that maintaining normoglycaemia with intensive insulin treatment in a heterogeneous population of critically ill patients decreases morbidity and mortality. The potential mechanisms that underlie such a beneficial effect are discussed. Associate Professor, Department of Intensive Care, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. johan.groeneveld@vumc.nl.