The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Intensive Insulin Therapy in Critically Ill Patients: NICE-SUGAR or Leuven Blood Glucose Target?
Abstract
CONTEXT: Hyper- and hypoglycemia are associated with increased mortality of critically ill patients, but whether this association is causal remains unclear. Early randomized-controlled studies compared insulin infusion targeting "age-normal" blood glucose levels, labeled intensive insulin therapy, with an approach that considered hyperglycemia as a beneficial adaptation. These studies found benefits with maintaining normoglycemia. A recent large multicenter study, NICE-SUGAR, compared a similar age-normal with an intermediate glucose target and found the intermediate target superior. These results require explanation. EVIDENCE ACQUISITION: All published randomized controlled studies on glucose control in ICU were reviewed. The methodological differences between the repeat studies, most specifically NICE-SUGAR, and the original proof-of-concept studies, were systematically analyzed. EVIDENCE SYNTHESIS: There were important methodological differences, possibly explaining different outcomes. These comprised different target ranges for blood glucose in control and intervention groups, different routes for insulin administration and types of infusion-pumps, different sampling sites, and different accuracies of glucometers, as well as different nutritional strategies and varying levels of expertise. CONCLUSIONS: These differences do not permit confident recommendations for a single optimal glucose target in variable ICU settings. Respecting the "primum non nocere" principle, it appears safe not to embark on targeting age-normal levels in ICUs that are not equipped to accurately and frequently measure blood glucose and have not acquired extensive experience with iv insulin administration using a customized guideline. A simple overall fall-back position could be to maintain blood glucose levels as close to normal as possible without evoking unacceptable fluctuations, hypoglycemia, and hypokalemia.
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Citations
Cites
Effects of Intensive Glucose Lowering in Type 2 Diabetes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0802743 · Cited by 7,888
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0802987 · Cited by 7,397
Intensive versus Conventional Glucose Control in Critically Ill Patients
(2009) · New England Journal of Medicine · doi:10.1056/nejmoa0810625 · Cited by 5,119
Glucose control and vascular complications in veterans with type 2 diabetes
Duckworth, W., Abraira, C., Moritz, T., Reda, D., Emanuele, N., Reaven, P. D., Zieve, F. J., Marks, J., Davis, S. N., Hayward, R., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0808431 · Cited by 4,762
Intensive insulin therapy in the medical ICU
Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., Van Wijngaerden, E., Bobbaers, H., & Bouillon, R. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052521 · Cited by 3,639
Self-citationIntensive insulin therapy and pentastarch resuscitation in severe sepsis
Brunkhorst, F. M., Engel, C., Bloos, F., Meier-Hellmann, A., Ragaller, M., Weiler, N., Moerer, O., Gruendling, M., Oppert, M., Grond, S., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa070716 · Cited by 2,921
Glycemic variability: A strong independent predictor of mortality in critically ill patients.
Krinsley, J. S. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e31818b38d2 · Cited by 729
Kosiborod, M., Rathore, S. S., Inzucchi, S. E., Masoudi, F. A., Wang, Y., Havranek, E. P., & Krumholz, H. M. (2005) · Circulation · doi:10.1161/circulationaha.104.517839 · Cited by 666
Vlasselaers, D., Milants, I., Desmet, L., Wouters, P. J., Vanhorebeek, I., van den Heuvel, I., Mesotten, D., Casaer, M. P., Meyfroidt, G., Ingels, C., et al. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60044-1 · Cited by 554
Self-citationArabi, 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
Cited by
Gustafsson, U. O., Scott, M. J., Schwenk, W., Demartines, N., Roulin, D., Francis, N., McNaught, C. E., MacFie, J., Liberman, A. S., Soop, M., et al. (2013) · World Journal of Surgery · doi:10.1007/s00268-012-1772-0 · Cited by 1,082
Low, D. E., Allum, W., De Manzoni, G., Ferri, L., Immanuel, A., Kuppusamy, M., Law, S., Lindblad, M., Maynard, N., Neal, J., et al. (2019) · World Journal of Surgery · doi:10.1007/s00268-018-4786-4 · Cited by 641
Lassen, K., Coolsen, M. M. E., Slim, K., Carli, F., de Aguilar‐Nascimento, J. E., Schäfer, M., Parks, R. W., Fearon, K. C. H., Lobo, D. N., Demartines, N., et al. (2013) · World Journal of Surgery · doi:10.1007/s00268-012-1771-1 · Cited by 473
The Sick and the Weak: Neuropathies/Myopathies in the Critically Ill
Friedrich, O., Reid, M. B., Van den Berghe, G., Vanhorebeek, I., Hermans, G., Rich, M. M., & Larsson, L. (2015) · Physiological Reviews · doi:10.1152/physrev.00028.2014 · Cited by 396
Self-citationHypoglycemia is associated with intensive care unit mortality*
Hermanides, J., Bosman, R. J., Vriesendorp, T. M., Dotsch, R., Rosendaal, F. R., Zandstra, D. F., Hoekstra, J. B. L., & DeVries, J. H. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181de562c · Cited by 236
Metadata
- Authors
- Van den Berghe, G., Schetz, M., Vlasselaers, D., Hermans, G., Wilmer, A., Bouillon, R., & Mesotten, D.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-09-01
- Volume
- 94
- Issue
- 9
- Pages
- 3163-3170
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1971323045
- Cited by
- 235
- References
- 10
- FWCI
- 23.92
- Type
- journal article
- Language
- en
- Open access
- closed
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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