Contrôle glycémique et états septiques

The septic response is tightly related to the carbohydrate metabolism. The “stress hyperglycaemia” linked with the resistance to insulin, systematically observed during sepsis, was considered as an adaptive mechanism. The increase of the infectious risk associated with hyperglycaemia, the alterations of the carbohydrate metabolism, the increased risk of hypoglycaemia, the metabolic and anti-inflammatory effects of insulin and the pro-inflammatory effects of hyperglycaemia are gathered within a physiopathological schema. Clinically, based on the currently available data, intravenous insulin therapy is recommended when blood glucose reaches the threshold of 1.5 g/l.