PubReading [101] - Glycemic control in the critically ill: Less is more - G. Alhatemi, B. Seyoum et al

<p><strong>Hyperglycemia</strong> is associated with poor clinical outcomes in critically ill patients. Initial clinical trials of intensive insulin therapy targeting blood glucose levels of 80 to 110 mg/dL showed improved outcomes, but subsequent trials found no benefits and even increased harm with this approach. Emerging literature has evaluated other glycemic indices including time-in-target <strong>blood glucose</strong> range, glycemic variability, and stress hyperglycemia ratio. These indices, while well described in observational studies, have not been addressed in the initial trials. Additionally, the patient’s preexisting diabetes status and preadmission <strong>diabetic</strong> control may modulate the outcomes of stringent glycemic control, with worse outcomes of hyperglycemia being observed in patients without diabetes and in those with well-controlled diabetes. Most medical societies recommend less stringent glucose control in the range of 140 to 180 mg/dL for critically ill patients. - doi:10.3949/ccjm.89a.20171 - 2022</p>