Riesgos y beneficios del tratamiento de la hiperglucemia en el paciente hospitalizado no crítico

Abstract

The prevalence of hyperglycemia in non-critical hospitalized patients is high, occurring in up to one third of patients not previously diagnosed with diabetes. Hyperglycemia increases hospital morbidity and mortality, the impact being greater in patients not known to be diabetics.

The effect of intensive treatment of hyperglycemia in non-critical hospitalized patients is unclear, the only proven benefit is the reduction in the risk of infection.

The current recommendation is to keep blood glucose levels <140 mg/dL, and to use the basal-bolus insulin therapy for the glycemic control during hospitalization. Although the fear of inducing hypoglycemia is one of the main causes of poor glycemic control, the evidence of its impact on hospital morbidity and mortality is very limited. Only spontaneous hypoglycemia at admission and is associated with increased hospital mortality.

There is an increased risk of iatrogenic hypoglycemia at discharge, so this should be carefully monitored.