What, why and how to monitor blood glucose in critically ill patients

Core Tip

Core Tip: Blood glucose (BG) monitoring is a vital component of critical care management. Even non-diabetic critically ill patients are prone to glycemic fluctuations necessitating frequent blood sampling and BG monitoring. Multiple medications, presence of underlying comorbidities and organ dysfunctions, and rapidly changing patient condition make BG control challenging in critically ill patients. Even the commonly used capillary blood sampling for BG monitoring may not be reliable in these patients. In addition to the established parameters of hypoglycemia and hyperglycemia, newer glycemic indices like glycemic variability and time in target range have also been recognized to affect outcomes of critically ill patients, further complicating BG monitoring. Devices for continuous glucose monitoring are also being increasingly tested in these patients, and their use in conjunction with artificial intelligence-based devices may provide a solution to comprehensive glucose control in the future.