International recommendations for glucose control in adult non diabetic critically ill patients
Open accessAbstract
Introduction: The purpose of this research is to provide recommendations for the management of glycemic control in critically ill patients. Methods: Twenty-one experts issued recommendations related to one of the five pre-defined categories (glucose target, hypoglycemia, carbohydrate intake, monitoring of glycemia, algorithms and protocols), that were scored on a scale to obtain a strong or weak agreement. The GRADE (Grade of Recommendation, Assessment, Development and Evaluation) system was used, with a strong recommendation indicating a clear advantage for an intervention and a weak recommendation indicating that the balance between desirable and undesirable effects of an intervention is not clearly defined. Results: A glucose target of less than 10 mmol/L is strongly suggested, using intravenous insulin following a standard protocol, when spontaneous food intake is not possible. Definition of the severe hypoglycemia threshold of 2.2 mmol/L is recommended, regardless of the clinical signs. A general, unique amount of glucose (enteral/parenteral) to administer for any patient cannot be suggested. Glucose measurements should be performed on arterial rather than venous or capillary samples, using central lab or blood gas analysers rather than point-of-care glucose readers. Conclusions: Thirty recommendations were obtained with a strong (21) and a weak (9) agreement. Among them, only 15 were graded with a high level of quality of evidence, underlying the necessity to continue clinical studies in order to improve the risk-to-benefit ratio of glucose control.
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An earlier meta-analysis showed that early enteral nutrition was associated with reduced mortality.
“An earlier meta-analysis (349) showed that early EN was associated with reduced mortality.”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [349]
The Discussion’s glucose-target section reports meta-analyses of glucose control and mortality, not early enteral nutrition. The carbohydrate-intake sections discuss enteral feeding but do not report a meta-analysis linking its early initiation to reduced mortality (searched: early enteral nutrition, enteral nutrition). (LLM, conf=0.75)
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Self-citationNear-Continuous Glucose Monitoring Makes Glycemic Control Safer in ICU Patients*
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Self-citationPerioperative Management of Oral Glucose-lowering Drugs in the Patient with Type 2 Diabetes
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Self-citationPerioperative management of adult diabetic patients. Intraoperative period
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Self-citationBlood sugar control in the intensive care unit: time to relook
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Successive Phases of the Metabolic Response to Stress
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Self-citationImpact of a Quality Improvement Project on Deceased Organ Donor Management
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Self-citationReporting on Glucose Control Metrics in the Intensive Care Unit
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Glukosekontrolle bei kritisch Kranken
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Self-citationComment gérer la nutrition artificielle chez un patient diabétique ?
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Should blood glucose be tightly controlled in the intensive care unit?
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Self-citationGlukosekontrolle bei kritisch Kranken
multizentrischen, A. G., & Heinz, G. (2013)
- Authors
- Ichai, C., Preiser, J.-C., (SFAR), F. T. S. F. D.-R., & Société de Réanimation de langue Française (SRLF) and the Experts group
- Affiliations
- Erasmus Hospital (BE)
- Société Française d'Anesthésie et de Réanimation (FR)
- Société de Réanimation de Langue Française (FR)
- Corresponding author
- Preiser, Jean-Charles
- Venue
- Critical Care
- Published
- 2010-09-14
- Volume
- 14
- Issue
- 5
- Pages
- R166-R166
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC3219261
- OpenAlex
- W2099537395
- Cited by
- 127
- References
- 108
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 10 · 2018: 11 · 2017: 11 · 2016: 11 · 2015: 13 · 2014: 19 · 2013: 11 · 2012: 7
- FWCI
- 6.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- HAL (submittedVersion, other-oa)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
- Funders
- Centre Hospitalier Universitaire Vaudois
- Société de Réanimation de Langue Française
- Société Française de Nutrition Entérale et Parentérale
- European Society of Intensive Care Medicine
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- glycemic control, critically ill patients, non-diabetic patients, glycemic targets, hypoglycemia, intravenous insulin, carbohydrate intake, glucose monitoring, arterial blood sampling, expert consensus recommendations, intensive care
- MeSH terms
- Adult, Age Factors, Blood Glucose, Critical Care, Glucose, Health Planning Guidelines, Humans, Insulin, Critical Illness, Glycemic Index, Internationality
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