Since publication of the NICE-SUGAR trial, this meta-analysis of 26 trials found no overall mortality benefit to tight glucose control in ICU patients. They did find a mortality benefit in the subset of surgical ICU patients (RR 0.63, CI 0.44-0.91). However, the overall risk of hypoglycemia (<40) was markedly higher in tight glucose control group (RR 6, CI 4.5-8.0). Outside of the surgical ICU, tight glucose control appears to do more harm than good (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.