Glycemic variability as a risk factor of intensive care unit-acquired weakness

Intensive care unit-acquired weakness (ICUAW) is a serious complication associated with loss of muscle mass and strength, metabolic disorders, organ failure, failure to wean, and increased mortality. ICUAW is diagnosed via MRC scores, and electrophysiological examinations (EP) can detect muscle excitability disorders associated with ICUAW (1). While uncontrolled hyperglycemia and/or insulin resistance has been linked to ICUAW (2), glucose variability, promoted by Krinsley et al as a crucial parameter independently linked to ICU mortality (3), has thus far been neglected in ICUAW studies. There is a lack of standardization in the assessment of glucose variability, and not all methods associate with mortality.