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

Armand R J Girbes, Albertus Beishuizen
Nederlands Tijdschrift Voor Geneeskunde 2009, 153: A609
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%.

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