[Insulin therapy on intensive care should not be too intensive]

Ned Tijdschr Geneeskd. 2009:153:A609.
[Article in Dutch]

Abstract

Intensive insulin therapy for critically ill patients is implemented as standard therapy in many ICUs, even though the evidence supporting this approach comes from just two studies at a single centre. Moreover, the results could not be repeated in other multicenter trials and there is increasing evidence of a risk of hypoglycaemia. However, it appears that many intensive care specialists have been too zealous in their attempts to attain euglycemia during critical care. A recent RCT with over 6000 patients demonstrated that intensive glucose control increases mortality by 2.4%.

Publication types

  • English Abstract

MeSH terms

  • Critical Care / methods*
  • Critical Illness / mortality
  • Critical Illness / therapy*
  • Dose-Response Relationship, Drug
  • Humans
  • Hypoglycemia / chemically induced*
  • Hypoglycemia / mortality
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Insulin / adverse effects*
  • Insulin / therapeutic use*
  • Intensive Care Units
  • Risk Assessment
  • Risk Management

Substances

  • Hypoglycemic Agents
  • Insulin