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Intensive Care Medicine

, Volume 42, Issue 9, pp 1478–1481 | Cite as

Blood glucose control in the ICU: don’t throw out the baby with the bathwater!

  • Jan Gunst
  • Greet Van den BergheEmail author
What's New in Intensive Care

In this issue of Intensive Care Medicine, Dr. Paul Marik presents his personal critical viewpoint on the use of tight glycemic control (TGC) in the intensive care unit (ICU) [1]. He recommends to abandon glycemic control altogether for critically ill patients, based upon a risk of harm that, in his interpretation, would outweigh any possible benefit. At first sight, Dr. Marik’s arguments appear reasonable. However, in our opinion, his argumentation was built on a biased/incomplete analysis of the evidence. We here present another (in our view more balanced) analysis. We argue that Dr. Marik is inadvertently recommending clinicians to throw out the baby with the bathwater.

Dr. Marik starts his case with an evolutionary perspective, stating that humans and animals alike reveal hyperglycemia when exposed to stress, and thus that this must be beneficial. We do not agree. Fasted young and lean human patients, as well as laboratory mice, in the absence of forced artificial nutrition and...

Keywords

Intensive Care Unit Hyperglycemia Hypoglycemia Glycemic Variability Tight Glycemic Control 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

GVdB receives research grants from the Research Foundation—Flanders, from the Methusalem Program funded by the Flemish Government (METH/14/06), and from the European Research Council under the European Union’s Seventh Framework Program (FP7/2013-2018 ERC Advanced Grant Agreement n° 321670).

Compliance with ethical standards

Conflicts of interest

The authors declare to have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2016

Authors and Affiliations

  1. 1.Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular MedicineKU LeuvenLouvainBelgium

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