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  Vol. 288 No. 17, November 6, 2002 TABLE OF CONTENTS
  JAMA
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  Contempo Updates: Linking Evidence and Experience
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CLINICIAN'S CORNER
Hyperglycemia in Acutely Ill Patients

Victor M. Montori, MD, MSc; Bruce R. Bistrian, MD, PhD; M. Molly McMahon, MD

JAMA. 2002;288:2167-2169.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Most physicians will encounter acutely ill patients who develop hyperglycemia. A third of all persons admitted to an urban general hospital had fasting glucose levels exceeding 126 mg/dL (7 mmol/L), or 2 or more random glucose levels exceeding 200 mg/dL (11.1 mmol/L); a third of those patients with hyperglycemia did not have a prior diagnosis of diabetes.1 Physicians often perceive hyperglycemia as a consequence of stress that runs parallel to the clinical course of an acute illness. Clinicians often start treatment of hyperglycemia only after glucose levels have exceeded 200 to 250 mg/dL (11-14 mmol/L). One reason for this is the perception that avoidance of hypoglycemia and its potential consequences is more important than glycemic control while patients are hospitalized. We discuss the evidence supporting the hyperglycemic milieu as a risk factor for adverse . . . [Full Text of this Article]

Pathophysiology of Hyperglycemia

Causes of Hyperglycemia

Effects of Hyperglycemia

Benefits of Controlling Hyperglycemia

Avoidance of Hypoglycemia

Author Affiliations: Division of Endocrinology, Metabolism, Nutrition and Internal Medicine, Mayo Clinic Rochester, and Mayo Medical School, Rochester, Minn (Drs Montori and McMahon); Division of Clinical Nutrition, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass (Dr Bistrian).



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