What would you do in this situation?

[Gurby]

Is the point they're researching the patient's BGL when admitted to the hospital from the ED or the patient's BGL when the patient arrives at the ED? Even though I've done precisely zero internet research into this matter at all, I highly suspect that the point that's being looked at is hospital admission. One of the reasons I suspect this is the case is that it's a whole lot easier to track serial BGL's on patients that are in a clinical setting than in the prehospital setting and unless the prehospital providers were all on-board with collecting that data, I doubt that checking an MI patient's BGL is going to be high on their "to-do" list.

Insulin is quite the interesting stuff... and not stuff that I would feel all that comfy with giving in the field to patients that don't already have a Type I DM diagnosis and therefore don't have insulin in their daily regimen, such as dealing with nutritional, correctional, and sliding scale doses.

The garden variety hyperglycemic patient probably doesn't need insulin right away. In any event, when the body is put under stress, cortisol is released and one of the outcomes of that is gluconeogenesis which leads to hyperglycemia anyway... at least "hyper" relative to their normal BGL.

At this point, if a BGL is checked, the info is "good to know" but leave the control of BGL to the ED. If the BGL isn't "HIGH" on the meter, it's better to be a bit elevated than too low. If you draw some blood and it looks like red Karo syrup, the BGL is probably way too high.

For our purposes my last post was basically academic speculation. There are a handful of theories about what causes the correlation and not enough evidence to really say.

Agree on not doing anything to address this BGL in the field.