McCowen · Critical care clinics 2001 · narrative review · n=?

Stress-induced hyperglycemia.

Cited 1180 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and expert opinion without systematic review methods or primary data

PubMed 11219223 · doi:10.1016/s0749-0704(05)70154-8 · record verified 2026-08-27

What was done

This is a narrative review detailing the mechanisms, clinical consequences, and management strategies for stress-induced hyperglycemia in critically ill hospitalized patients.

What was found

The abstract reports no experimental numbers or effect estimates. It states that stress hyperglycemia results from counterregulatory hormone and cytokine surges frequently compounded by dextrose administration (such as total parenteral nutrition). The authors describe their institutional practice of administering insulin to target plasma glucose concentrations between 150 mg/dL and 200 mg/dL.

Why it matters

The paper outlines early-2000s clinical practice and mechanism-based reasoning in critical care, calling attention to the absence of randomized trial data to guide glycemic targets in hospitalized patients.

Limits

This is a narrative review and institutional practice summary, not an empirical study or systematic review. No original patient data, sample sizes, or quantitative outcome measures are provided.

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