Critical illness or trauma may trigger a rise in levels of cortisol, noradrenaline and glycogen which stimulate glycogen and fat breakdown causing a rise in blood glucose levels. However, the normal mechanisms to increase insulin production may be impaired by critical illness. Additionally, sedation and causes of reduced level of consciousness can mask the neurological symptoms of hypo or hyperglycaemia, making it particularly important to monitor blood glucose in this group of patients. It is important that health professionals understand the physiological affects of hypo and hyperglycaemia and know the safeguards required in order to minimize the potential for erroneous or misleading blood glucose results, and improve care for this group of patients.
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