The significance of hyperglycaemia in survivors of critical illness and potential mechanisms underlying development of type 2 diabetes

Conditions of temporary glucose intolerance - such as gestational diabetes - identify people who are at risk from subsequently developing type 2 diabetes. This is important as the prompt diagnosis of glucose intolerance allows earlier treatment and a consequent reduction in complications associated with prolonged and untreated hyperglycaemia, dyslipidaemia and hypertension. The possibility that critical illness-associated hyperglycaemia (CIAH) could be a risk factor for subsequent type 2 diabetes has only been evaluated in one study. This study however has substantial limitations, which severely restrict interpretation of these data. If CIAH is a risk factor for development of type 2 diabetes, and the mechanisms underlying any glucose intolerance elucidated, survivors could be screened for diabetes and prompt appropriate therapy instituted.