Managing Diabetes and Endocrine Emergencies in Critical Care Units: A Multicenter Review of Internal Medicine Practices

Abstract

Background: Endocrine emergencies are frequently encountered in critically ill patients, either as a primary cause of admission or secondary to other critical illnesses. Prompt recognition and management of these emergencies can mitigate their severity and improve outcomes.
Objective: To review common endocrine emergencies in critically ill patients, emphasizing their recognition, underlying causes, and treatment strategies.
Methods: We are searching on databases like Google Scholar and PubMed. And use these words in the research box: "diabetic ketoacidosis," "adrenal insufficiency," "thyroid storm," or "critical care management." Relevance was ensured by giving priority to articles published in the recent 20 years.
Results: Acute adrenal insufficiency requires prompt diagnosis and administration of glucocorticoids to prevent hemodynamic collapse. Thyroid emergencies, such as thyroid storm or severe hypothyroidism (myxedema coma), necessitate early intervention with appropriate hormonal replacement and supportive measures. Hyperglycemic crises, including diabetic ketoacidosis and hyperosmolar hyperglycemic state, are life-threatening but manageable with rapid recognition and safe insulin therapy. Severe hypoglycemia demands immediate glucose administration to prevent critical complications.
Conclusions: Recognition and treatment of endocrine emergencies in critically ill patients can be lifesaving. Understanding the interplay between endocrine disorders and critical illness, and implementing appropriate management strategies, can significantly enhance patient outcomes.