Hyperglycaemia in critically ill patients : the immune system’s sweet tooth
CITATION: Van Niekerk, G., Davis, T. & Engelbrecht, A.-M. 2017. Hyperglycaemia in critically ill patients : the immune system’s sweet tooth. Critical Care, 21:202, doi:10.1186/s13054-017-1775-1.
The original publication is available at https://ccforum.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund.
There is an ongoing debate regarding the efficacy of glycaemic control in critically ill patients. Here we briefly highlight the key function of elevated glucose in critically ill patients, namely, to enable elevation of aerobic glycolysis in rapidly dividing cells. In particular, aerobic glycolysis provides metabolic intermediates necessary for expansion of biomass in immune cells and promotion of tissue repair. Furthermore, we emphasise that insulin may inhibit autophagy, a cell survival process used in the bulk degradation of cellular debris and damaged organelles. These observations provide a rational basis for tolerating elevated glucose levels in certain critically ill patients.