What is the recommended blood glucose level for critically ill patients?

• A. 140-180 mg/dL
• B. 70-110 mg/dL
• C. 200-250 mg/dL
• D. 90-120 mg/dL

Answer: (A)

In critically ill patients, the goal of glucose management is to avoid the harms of both high and low levels. Evidence shows that aiming for very tight control, such as 80–110 mg/dL, leads to more hypoglycemia and can worsen outcomes, including mortality. Because of this, the recommended target shifts to a moderate range that safely balances risk, which is about 140–180 mg/dL for most critically ill adults. This range helps reduce the complications associated with hyperglycemia—like impaired immune function and poor wound healing—while minimizing the danger of hypoglycemia from aggressive insulin therapy. Achieving this target typically requires careful, frequent glucose monitoring and insulin adjustments, with consideration for individual factors such as preexisting diabetes or certain medications. Levels well above 180 mg/dL are associated with worse outcomes, while targets that are too tight increase hypoglycemia risk without improving overall results.