, 1:1117
Date: 25 Sep 2012

Low blood sugar danger for critically ill

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medwireNews: Further analysis of the NICE-SUGAR trial shows a dose-response relationship between the degree of hypoglycemia and the risk for death in critically ill patients.

Simon Finfer (George Institute for Global Health, Sydney, Australia) and team assessed blood sugar levels for 6026 patients enrolled in the NICE-SUGAR (Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation) trial.

In all, 223 developed severe hypoglycemia (≤40 mg/dL; 2.2 mmol/L) and 35.4% of this group died. Almost all patients who developed severe hypoglycemia had been randomly assigned to receive intensive glucose control (target range 81–108 mg/dL; 4.5–6.0 mmol/L).

By contrast, 28.5% of 2714 patients with moderate hypoglycemia (41–70 mg/dL; 2.3–3.9 mmol/L) died, as did 23.5% of 3089 patients who maintained normoglycemia.

After adjustment for baseline and postrandomization variables, the risk for death was increased 1.41-fold among patients with moderate hypoglycemia and 2.10-fold am ...