, Volume 13, Issue 4, pp 301-305
Date: 19 May 2011

Understanding the Clinical Issues Involved with Glycemic Control in the Intensive Care Unit

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Paper 1 Van Den Berghe G, Wouters P, et al.; Intensive Insulin Therapy in Critically Ill Patients. N Engl J Med. 2001; 345:1359–1367

Rating: •Of importance.

Keywords Glycemic control·Intensive insulin·Intensive Care Unit (ICU)·Hyperglycemia·NICE-SUGAR·Glycemic variability·Advanced Glycolytic End-Products (AGES)

Introduction: Critically ill patients, even those without a history of diabetes, commonly have issues with insulin resistance and hyperglycemia, which can lead to a wide variety of complications. Van den Berghe et al. [1] hypothesized that this hyperglycemia, or relative insulin deficiency, may lead to increased death or other complications, and it is unknown whether normalization of blood glucose with insulin affects these patients’ outcomes.

Aims: In this study, the authors performed a prospective, randomized, controlled trial at one center to determine whether normalization of blood-glucose levels with intensive-insulin therapy (IIT) reduces mortality and morbidity among critical ...