Glycemic control: please agree to disagree
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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  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  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...
KeywordsHypoglycemia 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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