Correction of Stress Hyperglycemia in Patients with Acute Surgical Abdominal Diseases

Abstract

Critically ill patients admitted to intensive care units for the clinical manifestations of stress hyperglycemia represent a group in which attempts are most frequently undertaken to employ various methods of its correction. Objective: to compare different techniques for correction of stress hyperglycemia in patients with acute surgical abdominal disease complicated by peritonitis. Materials and methods: In this single-center randomized controlled trial, stress hyperglycemia was corrected by different procedures in 60 patients with acute surgical abdominal disease complicated by peritonitis. Results: As compared with traditional procedures for correction of stress hyperglycemia, the human insulin analogue aspart (Novorapid) improves stressful glycemic control and reduces the risk of hypoglycemia. During intensive insulin therapy, the ultrashort-acting insulin group showed showed a trend for a reduction in the number of manifestations of multiple organ failure and signs of systemic inflammation and decline in the number of hospital days. The least duration of mechanical ventilation was noted in the small-volume food group.

Keywords

• stress hyperglycemia
• critical conditions
• intensive insulin therapy.