Glucose control in the ICU
Abstract
Randomized, controlled trials aiming for near-normal glycemic targets (80 to 110 mg per deciliter [4.4 to 6.1 mmol per liter]) in critically ill patients have shown conflicting data regarding the benefits of intensive glycemic control (Table 1). In 2001, Van den Berghe et al. reported a dramatic 42% lower mortality among patients in the surgical intensive care unit (ICU) in whom the blood glucose level had been adjusted to 80 to 110 mg per deciliter than among those who had received conventional treatment that was initiated when glucose levels exceeded 215 mg per deciliter (11.9 mmol per liter), with a . . .
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Several multicenter studies, including the NICE-SUGAR trial, in critically ill hospitalized individuals in medical and surgical ICUs failed to replicate the Van den Berghe data.
“However, several multicenter studies, including the Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial, in critically ill hospitalized individuals in medical and surgical ICUs (29-31) failed to replicate these data.”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [29]
The findings from the NICE-SUGAR trial, supported by several meta-analyses, showed higher rates of hypoglycemia and an increase in mortality with more aggressive glycemic management goals compared with moderate glycemic goals.
“The findings from the NICE-SUGAR trial, supported by several meta-analyses showed higher rates of hypoglycemia and an increase in mortality with more aggressive glycemic management goals compared with moderate glycemic goals (29,32,33).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [29]
Cites
Arabi, Y. M., Dabbagh, O. C., Tamim, H. M., Al-Shimemeri, A. A., Memish, Z. A., Haddad, S. H., Syed, S. J., Giridhar, H. R., Rishu, A. H., Al-Daker, M. O., et al. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e31818f21aa · Cited by 471 · see citing works
De La Rosa, G. D. C., Donado, J. H., Restrepo, A. H., Quintero, A. M., González, L. G., Saldarriaga, N. E., Bedoya, M., Toro, J. M., Velásquez, J. B., Valencia, J. C., et al. (2008) · Critical Care · doi:10.1186/cc7017 · Cited by 319 · see citing works
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16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
- Authors
- Umpierrez, G. E.
- Affiliations
- Emory University (US)
- Corresponding author
- Umpierrez, Guillermo E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2023-09-28
- Volume
- 389
- Issue
- 13
- Pages
- 1234-1237
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W4387078208
- Cited by
- 21
- References
- 2
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 7 · 2023: 1
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- tight glycemic control, glycemic targets, critically ill patients, intensive care unit, mortality, hyperglycemia, hypoglycemia, surgical intensive care unit
- MeSH terms
- Glycemic Control, Blood Glucose, Humans, Intensive Care Units
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