Abstract
Hyperglycaemia is often present in patients admitted to intensive care units. It is associated with significantly increased mortality and morbidity, mainly in patients who did not have diabetes mellitus before hospitalisation.
According to many clinical studies, correcting hyperglycaemia leads to an improved prognosis for critically ill patients. Going by the latest recommendations, the glycaemia limits for critically ill patients should be between 7 and 10 mmol/l, with the exception of cardiologic patients, who may benefit from a tighter control of glycaemia levels.
There are various protocols in use for application of insulin doses by a nurse, for the purpose of blood sugar control in critically ill patients. Apart from the classical paper protocols there is already good experience with protocols based on mathematical or predictive models.
The application of the predictive model leads to better control of blood sugar in the selected limits, with lower incidence of hypoglycaemic episodes and lower variability of the measured glycaemia. In near future, development of a fully automated system can be expected, with the help of which glycaemia will be continuously monitored by a sensor in the device and the dose of insulin will be changed
