Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

According to AACE and ADA recommendations, what is the target blood glucose for critically ill patients?

1. Pre-meal BG should be less than 100

2. Random BG target should be less than 140

3. Target for critically ill patients should be 100-130

4. Target for critically ill patients should be 140-180

The correct answer is: Target for critically ill patients should be 140-180

The target blood glucose range of 140-180 mg/dL for critically ill patients is aligned with recommendations from both the American Association of Clinical Endocrinologists (AACE) and the American Diabetes Association (ADA). This target is recognized as optimal because it balances the need to avoid both hyperglycemia, which can exacerbate stress responses, and hypoglycemia, which can be harmful, especially in a critically ill population. In this context, maintaining blood glucose levels within the 140-180 mg/dL range has been shown to reduce the risk of complications and improve outcomes in critically ill patients. Strict glycemic control, with targets below this range, can lead to an increased risk of adverse events, including hypoglycemic episodes, which can be particularly dangerous in critical care settings. Establishing a higher target of 140-180 mg/dL allows healthcare providers to manage blood glucose effectively while mitigating the risks associated with overly aggressive treatment. The guideline takes into account the physiological stress that critically ill patients experience, recognizing that some degree of hyperglycemia is common and often unavoidable due to the stress response and metabolic demands of their condition.