Updated Guidelines for Nutritional and Metabolic Support in Critically Ill Patients with High Blood Sugar and Diabetes

Hyperglycemia is a major metabolic disturbance in critically-ill patients, linked to increased morbidity and mortality.

• Blood glucose levels should be controlled to avoid both hypoglycemia and elevated concentrations.
• Insulin is often necessary to maintain glucose levels within a normal range, particularly in avoiding tight glycemic control protocols.
• Adjusting energy intake to meet patients' requirements can prevent hyperglycemia and its complications.
• Protein intake should correspond to the level of metabolic stress experienced by the patient.
• Enteral nutrition is preferred over parenteral nutrition to reduce the risk of hyperglycemia and decrease insulin needs.
• Specific diets featuring low glycemic index carbohydrates, fiber, and monounsaturated fatty acids may enhance glycemic control with reduced insulin requirements.

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