Intensive Care Medicine

, Volume 42, Issue 9, pp 1482–1484 | Cite as

Glycemic control: please agree to disagree

  • Jean-Charles PreiserEmail author
  • Heleen M. Oudemans-van Straaten
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Real science depends for its progress on continual challenges to the current state of always-imperfect knowledge.

D. Sarewitz, Nature 2011;478:7.

Two dissenting views on glycemic control during critical illness were recently published in Intensive Care Medicine. The first interpretation by Marik [1] recommends a “no-touch” approach based on the adaptive and physiological properties of stress hyperglycemia, which provides a benefit that largely outweighs the risks of absolute or relative hypoglycemia associated with intensive insulin therapy. The second interpretation by Gunst and Van den Berghe [2] strongly advocates tight glycemic control by intensive insulin therapy (IIT) on the basis of the prevention of the toxicity of prolonged hyperglycemia, and on the favorable risk-to-benefit ratio reported in the pioneering clinical studies performed in Leuven [3, 4, 5].

These apparently irreconcilable viewpoints on the same set of data highlight the current status of our...


Hypoglycemia Glycemic Control Critical Illness Target Range Intensive Insulin Therapy 
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Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest


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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2016

Authors and Affiliations

  • Jean-Charles Preiser
    • 1
    Email author
  • Heleen M. Oudemans-van Straaten
    • 2
  1. 1.Department of Intensive Care, Erasme University HospitalUniversité Libre de BruxellesBrusselsBelgium
  2. 2.Department of Adult Intensive CareVU University Medical CentreAmsterdamThe Netherlands

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