This is the podcast surgery. I see rounds. My name is Jeff Guy. As you may be new to our podcast, I am an associate professor of surgery at Vanderbilt University of Medical Center. I'm the director of the burn center. My practice is limited debt to critical care and providing a lot of burn care. We use this podcast as a way of educating our house staff and fellows and has been really met with

a lot of popularity not only around the United States, but around the world of people who want

to talk about topics relative to critical care.

The topic that I want to talk about today is hyperglycemia in the intensive care unit.

This is a topic that seems to be getting a lot of mileage,

certainly at meetings as well as critical care journals,

and it's not a topic that's really new to people who take care of

critically injured burn patients.

A lot of what we do in caring for, the burn patient is control of their metabolism,

and we've learned perhaps decades ago that our patients, the burn victim, does better when

we control hyperglycemia as well as controlling their nabalism and catabolism.

The Center for Disease Control estimate that are roughly 18.2 million people, roughly 6.3% of our population, have diabetes in the United States.

About 41 million people are estimated to have a state of pre-diabetes.

And this is estimated to have an economic impact

in both direct and indirect costs five years ago in 2002 of roughly $132 billion.

It is clear that the prevalence of diabetes in the United States is increasing, but our

control of this disease is clearly deteriorating.

Roughly 4 million people are diagnosed that diabetes are admitted to the hospital in the United States each year.

And roughly 12.4% of all hospital discharges have diabetes listed as a diagnosis.

People with diabetes can be hospitalized for problems of life-threatening acute metabolic complications,

uncontrolled diabetes, things like diabetic, ketoacidosis.

Children and adolescents are frequently admitted to the hospital as they're worked up and started

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