Hyperglycemia and passive glucose uptake are commonly observed in patients with sepsis and severe illness and have been found to impair the microcirculation to peripheral nerves. Hyperglycemia has also been noted to contribute to energy depletion, leading to increased generation and reduced scavenging of reactive oxygen species, which results in mitochondrial dysfunction.14 Hyperkalemia and hypoalbuminemia may also promote endothelial edema and hypoxemia, resulting in tissue damage.