Intensive Care Medicine

, Volume 42, Issue 9, pp 1475–1477 | Cite as

Tight glycemic control in acutely ill patients: low evidence of benefit, high evidence of harm!

  • Paul E. MarikEmail author
What's New in Intensive Care

In 1878 Claude Bernard described hyperglycemia during hemorrhagic shock [1]. It is now well known that acute illness or injury may result in hyperglycemia, insulin resistance, and glucose intolerance, collectively termed stress hyperglycemia [2]. Stress hyperglycemia is an evolutionarily preserved adaptive response which provides the nervous and immune system with an immediate source of energy at a time of crisis. Insects, worms, and all vertebrates develop stress hyperglycemia when exposed to stress [2]. Stress hyperglycemia is a component of the stereotypic and coordinated response to stress referred to by Hans Selye as the “general adaption syndrome” which until 2001 was believed to be a beneficial host response which enhanced the host’s chances of survival [3]. On 8 November 2001, Van den Berghe and colleagues published a study entitled “Intensive insulin therapy in critically ill patients” in which they randomized 1548 surgical ICU patients (63 % who had undergone cardiac...


Hypoglycemia Glycemic Control Intensive Insulin Therapy Tight Glycemic Control Glucose Variability 
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Conflicts of interest

The author has no real or perceived conflict of interest with regards to the contents of this paper.


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© Springer-Verlag Berlin Heidelberg and ESICM 2016

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care MedicineEastern Virginia Medical SchoolNorfolkUSA
  2. 2.Eastern Virginia Medical SchoolNorfolkUSA

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