MANAGEMENT OF HYPERGLYCEMIA IN THE EMERGENCY: A LITERATURE REVIEW

Abstract

Management of hyperglycemia in emergencies is essential due to the global increase in diabetes and its complications, such as diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). Accurate management and timely treatment reduce mortality and improve clinical outcomes. This study, based on an integrative literature review, analyzed protocols and strategies for glycemic control. Articles from PubMed and BVS databases, as well as Brazilian guidelines, were evaluated. The findings indicate that intravenous insulin is the standard treatment, but requires strict monitoring to avoid hypoglycemia and electrolyte disturbances. The use of NPH insulin is recommended when the patient stabilizes and accepts a diet. Variable-rate insulin infusion has shown efficacy, but increased the incidence of hypokalemia, requiring potassium replacement. The study highlights that many hyperglycemic patients do not have a previous diagnosis of diabetes, making adequate screening essential. Continuous glucose monitoring appears to be a promising tool, although its use in emergencies is still limited. It is concluded that early glycemic control, combined with well-established protocols, improves clinical outcomes and reduces complications, highlighting the need for a balance between correction of hyperglycemia and prevention of hypoglycemia.