13
Table 7. Glycemic Targets for Inpatient Glycemic Control
Critically Ill Noncritically Ill
• Glucose 140–180 mg/dL
• Glucose <140 mg/dL may be
appropriate in some patients
• Glucose <110 mg/dL is not
recommended
• Premeal glucose <140 mg/dL
• Random glucose <180 mg/dL
• Reassess therapy for premeal glucose
<100 mg/dL
• Change therapy for premeal glucose
<70 mg/dL
Hydroxymethylbutyrate (HMB)
• HMB is a metabolite of leucine, an essential amino acid, and can be acquired
through both plant and animal foods such as grapefruit and catfish.
• HMB has been shown to:
▶ Decrease the proteolysis, increase the protein synthesis, decrease the apoptosis, and
increase the cell proliferation.
▶ Stabilize the muscle cell membrane and modulate protein degradation.
• When supplementing with HMB, current evidence suggests that either
1 g of HMB should be consumed 3 times per day or 1.5 g of HMB should be
consumed 2 times per day, for a total of 3 g of HMB daily (or 38 mg/kg of
bodyweight).
• One study has shown that a combination of these three nutrients arginine,
glutamine and HMB improves wound healing of DFUs in patients who have
poor limb perfusion and/or low albumin levels.
