From the Guidelines
High glucose levels should be treated to prevent complications, with insulin and/or other therapies initiated for persistent hyperglycemia above 180 mg/dL and a target glucose range of 140-180 mg/dL for most critically ill individuals. The treatment of high glucose levels is crucial to prevent both short-term and long-term complications, including diabetic ketoacidosis, hyperosmolar hyperglycemic state, heart disease, stroke, kidney disease, nerve damage, and eye problems 1. For hospitalized patients, the initiation of insulin therapy is recommended for treatment of persistent hyperglycemia starting at a threshold of 180 mg/dL, with a target glucose range of 140-180 mg/dL for the majority of critically ill patients and non-critically ill patients 1. Some key points to consider in the treatment of high glucose levels include:
- Initiation of insulin therapy for persistent hyperglycemia above 180 mg/dL
- Target glucose range of 140-180 mg/dL for most critically ill individuals
- More stringent goals, such as 110-140 mg/dL, may be appropriate for selected patients if they can be achieved without significant hypoglycemia
- Regular monitoring of blood glucose levels and medical follow-up are essential parts of management The findings from the NICE-SUGAR trial and several meta-analyses support the recommendation of moderate glycemic targets, such as 140-180 mg/dL, rather than intensive glycemic control, which may increase the risk of hypoglycemia and mortality 1.
From the FDA Drug Label
The main goal of treating diabetes is to lower your blood sugar to a normal level. High blood sugar can be lowered by diet and exercise, and by certain medicines when necessary.
Yes, high glucose should be treated. The goal of treating diabetes is to lower blood sugar to a normal level, and this can be achieved through diet, exercise, and medication when necessary 2.
From the Research
Treatment of High Glucose
- The treatment of high glucose levels is crucial in managing type 2 diabetes, as chronically elevated blood glucose levels are associated with significant morbidity and mortality 3.
- Studies have compared the effects of different insulin treatments, such as insulin glargine and metformin, on glycemic control in patients with type 2 diabetes 4, 5.
- Insulin glargine has been shown to provide better control of fasting plasma glucose (FPG) and overall interstitial glucose load compared to metformin 4.
- However, metformin treatment has been associated with an improvement in microvascular function 4.
Insulin Treatment Options
- Insulin detemir and insulin glargine are two long-acting insulin analogues that have been compared in several studies 5, 6.
- These studies have found that there is no clinically relevant difference in efficacy or safety between insulin detemir and insulin glargine for targeting hyperglycemia 5, 6.
- However, insulin detemir may be associated with less weight gain and a lower daily basal insulin dose compared to insulin glargine 5.
Novel Treatment Options
- Novel targets and mechanisms are being explored for the treatment of type 2 diabetes, including glucose-lowering effects and the development of new insulin therapies 7.
- These novel treatments aim to provide better glycemic control and reduce complications associated with type 2 diabetes 7.
- Examples of novel treatments include GLP-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and smart insulin preparations with a glucose-dependent mode of action 7.