Similar to a previous post (“Glucose control in and out of the ICU” from 10/08), another RCT of ICU patients were randomized to intensive (80-110) versus conventional (180-200) blood sugar control, and found no difference between the groups for the primary (ICU mortality) or secondary (hospital mortality, length of stay, infections, transfusions, dialysis, or duration of intubation) endpoints. They did find significantly more hypoglycemic events in the intensive group (29% versus 3% of patients). This study adds to the mounting evidence against intensive blood glucose control in ICU patients (abstract). An ongoing large RCT (NICE-SUGAR) will hopefully crystallize the risk-benefit ratio (NICE SUGAR)
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.